Idiopathic portal vein thrombosis not related to hepatic disease or malignancy

2021 ◽  
Vol 14 (11) ◽  
pp. e245620
Author(s):  
Samer Alkassis ◽  
Nathan Zaher ◽  
Zaid Kaloti ◽  
Diane Levine
Keyword(s):  
Portal Vein ◽  
Young Woman ◽  
Portal Vein Thrombosis ◽  
Unusual Case ◽  
Hepatic Disease ◽  
Rare Disorder ◽  
Abdominal Ct ◽  
Diagnostic Modality ◽  
Vein Thrombosis ◽  
Contrast Enhanced

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.

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

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

<p><strong>Objective:</strong>  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.</p><p><strong>Patients and Methods:</strong><strong>  </strong>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)</p><p><strong>Results:</strong><strong>  </strong>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.</p><p><strong>Conclusion:</strong><strong>  </strong>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.</p>

scholarly journals Diagnosis and management of portal vein thrombosis in patients with cirrhosis of liver

2018 ◽  
Vol 6 (26) ◽  
pp. 10-16
Author(s):  
Logan Adams ◽  
Somedeb Ball
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Common Complication ◽  
Portal Venous System ◽  
Vein Thrombosis ◽  
Contrast Enhanced ◽  
Chronic Complication ◽  
Hypertension Portal ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhosis Of Liver

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.

Portal vein thrombosis: etiology, diagnostic strategy, therapy and management

VASA ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 81-92 ◽  
Author(s):  
Hidajat ◽  
Stobbe ◽  
Griesshaber ◽  
Schroder ◽  
Felix
Keyword(s):  
Portal Vein ◽  
Digital Subtraction Angiography ◽  
Portal Vein Thrombosis ◽  
Mr Angiography ◽  
Doppler Sonography ◽  
Digital Subtraction ◽  
Mechanical Recanalization ◽  
Vein Thrombosis ◽  
Contrast Enhanced ◽  
Local Fibrinolysis

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.

Role of diffusion-weighted MR imaging in differentiation between malignant and benign portal vein thrombosis in patients with Hepatocellular carcinoma

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Hussien ◽  
Allam El Sayed Allam ◽  
Amr Mohamed Kamal Moharram
Keyword(s):  
Retrospective Study ◽  
Mr Imaging ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Daily Routine ◽  
Reference Standard ◽  
Vein Thrombosis ◽  
Diffusion Weighted ◽  
Contrast Enhanced

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.

scholarly journals EUS-FNA of a portal vein thrombosis in a patient with a hidden hepatocellular carcinoma: confirmation technique after contrast-enhanced ultrasound

Endoscopy ◽  
2014 ◽  
Vol 46 (S 01) ◽  
pp. E590-E591 ◽  
Author(s):  
Miguel Moreno ◽  
Antonio Gimeno-García ◽  
María Corriente ◽  
David Nicolás-Pérez ◽  
Alejandro Brito-García ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Contrast Enhanced Ultrasound ◽  
Vein Thrombosis ◽  
Contrast Enhanced

Prediction of the therapeutic effects of anticoagulation for recent portal vein thrombosis: a novel approach with contrast-enhanced ultrasound

2011 ◽  
Vol 37 (3) ◽  
pp. 431-438 ◽  
Author(s):  
Hitoshi Maruyama ◽  
Hiroyuki Ishibashi ◽  
Masanori Takahashi ◽  
Taro Shimada ◽  
Hidehiro Kamesaki ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Therapeutic Effects ◽  
Contrast Enhanced Ultrasound ◽  
Vein Thrombosis ◽  
Novel Approach ◽  
Contrast Enhanced
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