Portal vein thrombosis-experience with Color-Doppler technique

Liver transplantation (LT) is a serious hemostatic challenge in patients with portal vein thrombosis (PVT). Advances in monitoring systems have improved surgery in this setting. We report the successful application of a point-of-care (POC) rotational viscoelastic thromboelastometry-guided (TEM) testing system (ROTEM) which allowed management of coagulation during LT in a 64-year-old cirrhotic patient with a model for end-stage liver disease (MELD) score of 16. Perioperatively, the patient showed complete PVT, hepatomegaly, splenomegaly, recanalization of the umbilical vein, and portosystemic shunt. Macroscopic liver and spleen adherences with collateral circulation were evident. Coagulation factors and fibrinolysis were assessed preoperatively and at graft reperfusion to evaluate the need of hemostatic therapy. Based on ROTEM findings, the patient received 16 g of human fibrinogen concentrate, half preoperatively (with prothrombin complex concentrate 2000 IU, tranexamic acid 1 g, and platelets 2 IU), and two doses of 4 g before and after graft reperfusion; we achieved normalization of all monitored parameters. No ischemia-reperfusion syndrome was present. Postoperatively portal vein flux at Color-Doppler ultrasonography was normal. After a 3-day ICU stay, the patient was moved to the Department of Surgery and discharged on day 14. The postoperative course was uneventful and did not require any further haemostatic therapy.

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Color Doppler US and tri-phasic CT in differentiating benign from malignant portal vein thrombosis (PVT)

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2015.09.002 ◽

2015 ◽

Vol 46 (4) ◽

pp. 847-857

Author(s):

Atef H. Teama ◽

Aly A. Elbarbary ◽

Khaled E. Elhawary ◽

Wafaa A. Abusekina

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Color Doppler ◽

Vein Thrombosis ◽

Doppler Us ◽

Color Doppler Us

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Hemodynamic Changes in Portal Vein and Frequencies of Acute and Chronic Portal Vein Thrombosis in Pediatric Patients Presenting with Hematemesis

Annals of King Edward Medical University ◽

10.21649/akemu.v22i4.1443 ◽

2016 ◽

Vol 22 (4) ◽

Author(s):

Ahmad Imran ◽

Amna Tariq ◽

Abid Ali Qureshi

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Doppler Ultrasound ◽

Pediatric Patients ◽

Color Doppler ◽

Cost Effective ◽

Color Doppler Ultrasound ◽

Diagnostic Modality ◽

Cross Sectional ◽

Vein Thrombosis

Objective: The objective of the study is to calculate the frequency of portal vein thrombosis in pediatric patients presenting with hematemesis and to estimate the frequency of acute and chronic portal vein thrombosis in these cases.Patients and Methods: Pediatric patients of 1 – 15 years of age of either sex, presenting to emergency or gastroenterology department with complaint of hematemesis were included. Informed consent was taken from parents/guardians. This is a Descriptive cross sectional study conducted in department of pediatric radiology, Children Hospital and Institute of child Health Lahore from 11-12-2012 to 10-6-2013. Doppler ultrasound of these patients was performed at Core Vision pro SSA 350-A Doppler machine (Toshiba, Japan) using standard imaging protocols. The data was analyzed using SPSS version 17.0 (SPSS Inc., IL, Chicago, USA)Results: In this study, 41% (n = 41) between 1 – 5 years, 38% (n = 38) between 6 – 10 years and only 21% (n = 21) between 11 – 15 years of age, 64%( n = 64) were male and remaining 36% (n = 36) were females, frequency of portal vein thrombosis in pediatric patients presenting with hematemesis reveals in 37% (n = 37) while 63% (n = 63) had no findings of PVT, frequency of acute and chronic forms in patients positive for portal vein thrombosis was 40.54% (n = 15) had acute and 59.46% (n = 22) had chronic portal vein thrombosis.Conclusion: We concluded that the frequency of portal vein thrombosis in pediatric patients presenting with hematemesis and frequency of acute and chronic forms in patients positive for portal vein thrombosis is in accordance with other studies while color Doppler ultrasound is a useful diagnostic modality being noninvasive and cost effective.

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Endoscopic and transabdominal color doppler ultrasound in diagnosis of common bile duct varices in patients with portal vein thrombosis

Endoscopy ◽

10.1055/s-2006-947630 ◽

2006 ◽

Vol 39 (S 1) ◽

Author(s):

I Grgurevic ◽

Z Babic ◽

M Banic ◽

Z Cabrijan ◽

D Kardum ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Doppler Ultrasound ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Vein Thrombosis

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Changes in the Velocity of Blood in the Portal Vein in Mild Acute Pancreatitis—A Preliminary Clinical Study

Medicina ◽

10.3390/medicina55050211 ◽

2019 ◽

Vol 55 (5) ◽

pp. 211

Author(s):

Artautas Mickevičius ◽

Jonas Valantinas ◽

Juozas Stanaitis ◽

Tomas Jucaitis ◽

Laura Mašalaitė

Keyword(s):

Acute Pancreatitis ◽

Blood Flow ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Color Doppler ◽

Control Group ◽

Main Portal Vein ◽

Vein Thrombosis ◽

Mild Acute Pancreatitis

Background and objective: Portal vein thrombosis is associated with a decrease in the main blood velocity in this vessel. While most studies examine etiological factors of portal vein thrombosis after its occurrence, we aimed to evaluate portal vessels and assess whether mild acute pancreatitis affects blood flow in the portal vein and increases the risk of thrombosis. Materials and methods: This prospective single centered follow-up study enrolled 66 adult participants. Fifty of them were diagnosed with mild acute pancreatitis based on the Revised Atlanta classification, and 16 healthy participants formed the control group. All participants were examined three times. The first examination was carried out at the beginning of the disease and the next two at three-month intervals. Blood samples were taken and color Doppler ultrasound performed the first time, whereas ultrasound alone was performed during the second and third visits. Mean and maximal blood velocities and resistivity index in the main portal vein and its left and right branches were evaluated. Results: Mean velocity of the blood flow in the main portal vein and its right and left branches was not significantly different from healthy individuals during the acute pancreatitis phase: 23.1 ± 8.5 cm/s vs. 24.5 ± 8.2 cm/s (p = 0.827); 16.4 ± 7.9 cm/s vs. 16.4 ± 8.1 cm/s (p = 1.000); and 8 ± 3.4 cm/s vs. 7.4 ± 2.5 cm/s (p = 0.826), respectively. The same was observed when comparing the maximal blood flow velocity: 67.9 ± 29 cm/s vs. 67.5 ± 21 cm/s (p > 0.05); 45.4 ± 27 cm/s vs. 44 ± 23.8 cm/s (p = 0.853); and 22.2 ± 9.8 cm/s vs. 20 ± 7.3 cm/s (p = 0.926), respectively. Changes in venous blood velocities were not significant during the follow-up period in separate study groups. Conclusions: Portal blood flow velocities do not change during mild acute pancreatitis in the inflammatory and postinflammatory periods. This observation suggests that mild acute pancreatitis does not increase the risk of portal vein thrombosis.

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