546 THE USE OF CONTRAST-ENHANCED SONOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS BETWEEN BENIGN AND MALIGNANT PORTAL VEIN THROMBOSIS

2010 ◽  
Vol 52 ◽  
pp. S218
Author(s):  
L. Alexandrescu ◽  
E. Dumitru ◽  
I.-T. Tofolean ◽  
A. Suceveanu ◽  
M. Moise
2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Işık Üstüner ◽  
Remzi Adnan Akdoğan ◽  
Emine Seda Güvendağ Güven ◽  
Figen Kır Şahin ◽  
Şenol Şentürk ◽  
...  

Portal vein thrombosis (PVT) can be chronic or acute in nature; it is characterized by a thrombus formation in the main portal vein and/or its right or left branches. Herein, we present a 36-year-old woman with asymptomatic noncirrhotic chronic PVT who developed preeclampsia in the later stage of pregnancy. This report will emphasize the clinical differential diagnosis, outcome, and management of pregnancies complicated by noncirrhotic PVT.


2021 ◽  
pp. 92-101
Author(s):  
T. V. Penkina ◽  
O. E. Berezutskaya ◽  
D. T. Dicheva ◽  
E. V. Partsvania-Vinogradova ◽  
V. S. Larina ◽  
...  

In the article we analysed the difficulties of differential diagnosis of portal hypertension, considers a clinical case that illustrates the presented theoretical material. In the presented clinical observation, the patient’s disease was manifested by bleeding from the varicose veins of the esophagus. In most cases, portal hypertension syndrome in practicing clinicians is associated with liver cirrhosis, however, it is necessary to remember about the possibility of developing subhepatic portal hypertension, in particular as a result of the formation of portal vein thrombosis. If there are signs of portal hypertension, it is necessary to specify the level of obstruction to blood flow, that is, the form of portal hypertension (subhepatic, hepatic, suprahepatic). Often, portal vein thrombosis can be formed due to undiagnosed blood diseases that occur without any clinical symptoms. The provided clinical example demonstrates a case of portal hypertension in the outcome of a chronic form of myeloproliferative syndrome. Portal cavernoma is quite rare and it is formed due to multiple small-diameter venous structures that gradually replace the occluded vessel with a system of collaterals proximal and distal to the portal vein thrombosis site. In the formation of the diagnosis the main are radiation research methods, but the conclusions should be considered only in conjunction with the clinical evidence. The clinical case is interesting because a large cavernoma of the portal vein in a patient with subhepatic portal hypertension was regarded as a «solid formation» according to magnetic resonance tomography. According to the literature data, cavernous transformation has an external similarity to the tumor process, which expands the range of differential diagnosis and requires the exclusion of oncological formations. 


2018 ◽  
Vol 6 (26) ◽  
pp. 10-16
Author(s):  
Logan Adams ◽  
Somedeb Ball

Portal vein thrombosis (PVT) is an occlusion of the portal venous system and is a common complication of liver cirrhosis. It can present as either an acute or chronic complication. Acute PVT can present with abdominal pain, diarrhea, ileus, and bleeding. Chronic PVT is often asymptomatic; however, it can be discovered in cases of worsening portal hypertension. Portal vein thrombosis is diagnosed by imaging modalities, such as ultrasound and computed tomography. Contrast-enhanced imaging can be used in cases with difficult visualization. Despite the hemostatic imbalance in cirrhosis, anticoagulants can be safely used to recanalize the vein. Transjugular intrahepatic portosystemic shunt procedures are also an effective method for recanalization.


VASA ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 81-92 ◽  
Author(s):  
Hidajat ◽  
Stobbe ◽  
Griesshaber ◽  
Schroder ◽  
Felix

Myeloproliferative disorder, liver cirrhosis with portal hypertension, deficiency of natural anticoagulant proteins, gene mutation and hepatocellular carcinoma are the most frequent causes of portal vein thrombosis (PVT). Higher accuracy of the diagnostic methods is the reason why today the cause of PVT can be found more frequently. With imaging methods, PVT with or without cavernous transformation can be diagnosed. Fresh thrombus can be undetected in sonography due to the low echogenity but can be recognized in color Doppler sonography, especially with contrast-enhancing agent. Contrast-enhanced 3D MR angiography allows a comparable accuracy in the detection of PVT as digital subtraction angiography. Therapeutical options of PVT consist of mechanical recanalization of the portal vein, local fibrinolysis with or without placement of transjugular intrahepatic portosystemic stent shunt (TIPS), combination of mechanical recanalization and local fibrinolysis, systemic thrombolytic therapy, anticoagulation alone and surgical thrombectomy. Once PVT is found in sonography, Doppler sonography may be performed in order to distinguish benign from malignant thrombus. If further information is needed, MR angiography or contrast enhanced CT is the next step. If these tests are unsatisfactory, digital subtraction angiography should be performed. Until the early nineties, shunt surgery was recommended in patients with PVT who bled despite endoscopic treatment. Today, in symptomatic noncavernomatous PVT, recanalization with local methods is recommended. Additional implantation of TIPS should be performed when the patient is cirrhotic. In recent PVT in non-cirrhotic patients anticoagulation alone is recommended. It is expected that in old PVT anticoagulation can prevent further extension of the thrombus.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Hussien ◽  
Allam El Sayed Allam ◽  
Amr Mohamed Kamal Moharram

Abstract Background Differentiation between malignant and bland thrombus of the portal vein in patients who have HCC using diffusion weighted MR imaging. Objective To determine the role of DW imaging in differentiating between the benign and malignant portal vein thrombosis in patient with HCC. Patients and Methods This is a retrospective study done in ain-shams hospitals and private centers. This is a retrospective study done in Ain-Shams Hospitals and private centers. We studied 20 cases, 13 males and 7 females with total mean age 59.5. Results Our study had some limitations. First, we did not use pathologic findings as our reference standard for characterizing the thrombi; instead, we have used accepted imaging criteria as a reference standard. In our study, we used oval ROI placement and although we avoided averaging ADC of the thrombus with the surrounding structures “by enlarging the images and placing the ROI within the thrombus “, we cannot completely exclude that some averaging could have occurred in the smallest thrombi. Conclusion In addition to the initial diagnosis of the PVT nature, subsequent contrast-enhanced MRI is actually necessary to evaluate further treatment response in daily routine. But the administration of I.V. contrast agent is problematic especially in patients with renal insufficiency. Therefore, DWI technique can be utilized in adjunction with routine MRI protocols to determine the nature of PVTs by the calculation of ADCs values.


2021 ◽  
Vol 14 (11) ◽  
pp. e245620
Author(s):  
Samer Alkassis ◽  
Nathan Zaher ◽  
Zaid Kaloti ◽  
Diane Levine

Acute portal vein thrombosis (PVT) is a rare disorder defined by the sudden occlusion of the portal vein, which could be partial or complete. Prothrombotic states, inherited or acquired, are thought to be the cause in patients without cirrhosis or malignancy. However, the aetiology of some cases remains idiopathic despite a multidisciplinary diagnostic approach. The initial diagnostic modality to confirm PVT is either contrast-enhanced abdominal (CT) or MRI; as it can identify predisposing factors, and detect evidence of complications. Eliciting the underlying aetiology is critical to guide overall management and prevent future recurrence. The purpose of treatment is to stop thrombus extension and achieve portal vein patency by anticoagulation to optimise outcomes. Herein, we present an unusual case of spontaneous PVT in a young woman. We will also discuss the evaluation of patients without obvious aetiology.


Endoscopy ◽  
2014 ◽  
Vol 46 (S 01) ◽  
pp. E590-E591 ◽  
Author(s):  
Miguel Moreno ◽  
Antonio Gimeno-García ◽  
María Corriente ◽  
David Nicolás-Pérez ◽  
Alejandro Brito-García ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document