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Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

Although spontaneous resolution of PVT has been reported in the literature[], a specific therapeutic management is mandatory to resolve portal vein obstruction and avoid serious complications. PVT can be classified into four categories, depending on the extension: The principal diagnostic criteria are usually incompletely met in these patients, probably because of the atypical manifestation of the disease[ 50 poeta.

However, among patients with PVT, survival seems better in low grades of Yerdel classification; however, further studies are needed to confirm caverjoma data. Liver transplantation in adults.

Malformación cavernomatosa de la vena porta

Extrahepatic portal vein thrombosis: Table 1 Most frequent local risk factors for PVT[ 38917186479 ]. Valla DC, Condat B. In addition, collateral circulation develops rapidly from pre-existing veins in the porta hepatis within 2 to 3 d after the onset of acute thrombosis, particularly in the gallbladder wall[ 619495 ].

Table 5 Intraoperatory grading of PVT extension[ 17 ]. Furthermore, in the diagnostic iter, the identification of possible local or systemic trigger factors is of primary importance however, occasionally no single factor is discernable.

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Recently, a panel of experts recommended the application of anticoagulant therapy only in PVT patients with a proven thrombophilic disorder or familial history of venous thrombosis[], thereby obtaining an improvement in survival and reduction in risk of gastrointestinal bleeding[].


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Table 3 Prevalence of thrombotic risk factors in series of routinely investigated, consecutive adult patients with non tumorous and non cirrhotic, acute or chronic, PVT[ ]. Bacteroides species and thrombotic events, such as PVT[ 40 – 43 ]. The spectrum caverboma portal vein thrombosis in liver transplantation. Mesenteric venous thrombosis to In the past, PVT was considered an absolute contraindication for liver transplantation.

Ultrasound-guided fine needle aspiration biopsy of portal vein thrombosis in liver cirrhosis: Protean manifestations of pylethrombosis. Cirrhosis Preserved liver function with precipitating factors splenectomy, surgical portosystemic shunting, TIPS dysfunction, thrombophilia Advanced disease in the absence of obvious precipitating factors. Lai L, Brugge WR. Although PVT might be compared to other cases of deep vein thrombosis, there is no randomized controlled trial regarding the use of anticoagulants in acute PVT[ ].

In acute PVT, the possibility of intestinal infarction should be cavefnoma from presentation until resolution of pain.

Porga contrast, chronic PVT can be completely asymptomatic, or characterized by splenomegaly, pancytopenia, varices, and, rarely, ascites[ 3 ].

Single center experience of 39 patients with preoperative portal vein thrombosis among adult living donor liver transplantations. A population-based autopsy study. PVT onset can be vema or chronic.

Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension.

Anticoagulation in cirrhotic patients The ubiquitous and long-term use of anticoagulants in cirrhotic patients caavernoma PVT should not be considered correct practice, until their safety and efficacy has been completely tested[ 62 ]. Percutaneous transhepatic treatment of symptomatic mesenteric venous thrombosis. Portal vein thrombosis in cirrhotics: Cavernous transformation of the portal vein: Male sex, previous treatment for PVT, Cagernoma class C, and alcoholic liver disease might be associated with recurrence[ 85].

Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Thus, PVT seems more frequent than expected: Condat B, Valla D. Portal vein grafts in hepatic transplantation.


Several studies[ – ] showed that surgical thrombectomy, thromboendovenectomy with venous reconstruction, interposition of vein graft, porto-caval hemitransposition, and radiological endovascular interventions, can resolve venous obstruction in liver transplant recipients[ ]. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis. However, levels of prothrombin and other coagulation factors could be moderately decreased, while D-dimer is usually increased[ 822 ].

The clinical suspicion is often based on the incidental finding of hypersplenism, signs of portal hypertension or, less frequently, symptoms of portal cholangiopathy. The term portal vein thrombosis PVT refers to dr complete or partial obstruction of favernoma flow in the portal vein, due to the presence of a thrombus in the vasal lumen[ 1 ]. Report of a case. Transjugular intrahepatic portosystemic shunt TIPS in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients.

Consider a diagnosis of chronic PVT in any patient with newly diagnosed portal hypertension.

Treatment of portal venous thrombosis with selective superior mesenteric artery infusion of recombinant tissue plasminogen activator. Current outcome of portal vein thrombosis in adults: A prospective evaluation of primary myeloproliferative disorders.

Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

The consequent changes in hepatic and splanchnic hemodynamic are responsible for a mild impairment in liver function, in absence of an overt liver disease, or can lq a preexistent metastable clinical status in cirrhotic patients. Clinical experience and surgical treatment in patients. In contrast, a distal spleno-renal shunt or an H-type meso-caval shunt, in the same condition, didnot seem to be equally effective, probably due to insufficient residual portal vein flow and the consequent impairment in liver synthetic function[ 29 ].

Nonmalignant portal vein thrombosis in adults.