Advertisement

The problem with incidental and chronic portal vein thrombosis

Published:January 08, 2017DOI:https://doi.org/10.1016/j.ejim.2017.01.004
      Thrombosis in the portal vein (PVT) can occur at any point along its course from the junction of the splenic vein and the superior mesenteric vein [
      • DeLeve L.D.
      • Valla D.C.
      • Garcia-Tsao G.
      • American Association for the Study of Liver Diseases
      Vascular disorders of the liver.
      ]. Classically, PVT is described to present with sudden-onset right upper-quadrant pain, abdominal swelling/ascites and hepatomegaly [
      • Amitrano L.
      • Guardascione M.A.
      • Brancaccio V.
      • et al.
      Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis.
      ]. In such cases, clinical suspicion is high and management is relatively straightforward with anticoagulation in the absence of contraindications. We analysed all cases of PVT in our institution over a two-year period to determine clinical presentation, imaging and management of the patients.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • DeLeve L.D.
        • Valla D.C.
        • Garcia-Tsao G.
        • American Association for the Study of Liver Diseases
        Vascular disorders of the liver.
        Hepatology. 2009; 49: 1729-1764
        • Amitrano L.
        • Guardascione M.A.
        • Brancaccio V.
        • et al.
        Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis.
        J Hepatol. 2004; 40: 736-741
        • Berzigotti A.
        • García-Criado A.
        • Darnell A.
        • García-Pagán J.C.
        Imaging in clinical decision-making for portal vein thrombosis.
        Nat Rev Gastroenterol Hepatol. 2014; 11: 308-316
        • Condat B.
        • Pessione F.
        • Hillaire S.
        • et al.
        Current outcome of portal vein thrombosis in adults: risk and benefit of anticoagulant therapy.
        Gastroenterology. 2001; 120: 490-497
        • Lamps L.W.
        • Hunt C.M.
        • Green A.
        • Gray Jr., G.F.
        • Washington K.
        Alterations in colonic mucosal vessels in patients with cirrhosis and noncirrhotic portal hypertension.
        Hum Pathol. 1998; 29: 527-535
        • Jairath V.
        • Burroughs A.K.
        Anticoagulation in patients with liver cirrhosis: complication or therapeutic opportunity?.
        Gut. 2013; 62: 479-482
        • Colaizzo D.
        • Amitrano L.
        • Tiscia G.L.
        • et al.
        The JAK2 V617F mutation frequently occurs in patients with portal and mesenteric venous thrombosis.
        J Thromb Haemost. 2007; 5: 55-61
        • De Stefano V.
        • Qi X.
        • Betti S.
        • Rossi E.
        Splanchnic vein thrombosis and myeloproliferative neoplasms: molecular-driven diagnosis and long-term treatment.
        Thromb Haemost. 2016; 115: 240-249