Portal Hypertensive Cholangiopathy, Which Masquerades as an Acute Portal Vein Thrombosis

Portal hypertensive cholangiopathy is a rare complication of extrahepatic portal vein obstruction and portal cavernoma. It is usually asymptomatic but may be associated with jaundice, biliary colic, and fever. Abdominal sonography and Doppler are ideal initial diagnostic modalities, followed by magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography. These imaging modalities are important if an intervention is planned for the management of portal hypertension and for relieving biliary obstruction. If computed tomography (CT) is performed in isolation, it may be challenging to distinguish this entity from acute on chronic portal vein thrombosis. The diagnostic results should be interpreted cautiously. This case report of an abdomen CT performed on a patient with a history of portal vein thrombosis masqueraded as an acute on chronic portal vein thrombosis with cavernous collaterals. Doppler confirmed the diagnosis of portal hypertensive cholangiopathy. Correlation with clinical symptoms and Doppler may be necessary to distinguish portal hypertensive cholangiopathy from acute portal vein thrombus.

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Difficulties of differential diagnosis of portal hypertension: case report

Medical Council ◽

10.21518/2079-701x-2021-5-92-101 ◽

2021 ◽

pp. 92-101

Author(s):

T. V. Penkina ◽

O. E. Berezutskaya ◽

D. T. Dicheva ◽

E. V. Partsvania-Vinogradova ◽

V. S. Larina ◽

...

Keyword(s):

Differential Diagnosis ◽

Portal Hypertension ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Clinical Case ◽

Clinical Symptoms ◽

Varicose Veins ◽

Small Diameter ◽

Magnetic Resonance Tomography ◽

Vein Thrombosis

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.

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Acute Pancreatitis: A Rare Complication After Percutaneous Mechanical Thrombectomy of Portal Vein Thrombosis

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.09.069 ◽

2020 ◽

Author(s):

Qiyang Xu ◽

Yi Wang ◽

Di Wang ◽

Bin Xu ◽

Leibo Yang ◽

...

Keyword(s):

Acute Pancreatitis ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Mechanical Thrombectomy ◽

Rare Complication ◽

Percutaneous Mechanical Thrombectomy ◽

Vein Thrombosis

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Hydatid cyst of the liver with portal thrombosis: A case report

10.22541/au.163422255.59467088/v1 ◽

2021 ◽

Author(s):

Nasrin Milani ◽

Najme Majidi ◽

Laden Goshayeshi

Keyword(s):

Case Report ◽

Portal Vein ◽

Hydatid Cyst ◽

Portal Vein Thrombosis ◽

Rare Complication ◽

Liver Cyst ◽

Diagnosis And Treatment ◽

Portal Thrombosis ◽

Vein Thrombosis ◽

Extensive Involvement

The extensive involvement of the liver due to hydatid cyst and it’s invasion to the portal vein and resulted portal vein thrombosis are rare complications of hydatid cyst. The diagnosis and treatment of hydatid liver cyst and its rare complication such as thrombosis in infected patients should be critically considered.

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Splenic and portal vein thrombosis following laparoscopic splenectomy in a pediatric patient with chronic myeloid leukemia

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000500008 ◽

2006 ◽

Vol 124 (5) ◽

pp. 275-277 ◽

Cited By ~ 2

Author(s):

Henrique Manoel Lederman ◽

Evan Fieldston

Keyword(s):

Magnetic Resonance ◽

Chronic Myeloid Leukemia ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Laparoscopic Splenectomy ◽

Myeloid Leukemia ◽

Rare Complication ◽

Marrow Transplant ◽

Vein Thrombosis ◽

Increased Risk

CONTEXT: Splenic or portal vein thrombosis is a rare complication following splenectomy. CASE REPORT: We report a case of splenic and portal venous thrombosis in a 10-year-old girl with chronic myeloid leukemia who underwent laparoscopic splenectomy prior to bone marrow transplant. Clinical suspicion of such thrombosis should be high for patients who have had splenectomy. The diagnosis is confirmed by Doppler ultrasound or contrast-enhanced computed tomography; magnetic resonance imaging magnetic resonance angiography or arteriography can also be used. Proposals for postoperative screening protocols are discussed. Patients with primary myeloproliferative disorders are at increased risk of portal vein thrombosis, independent of surgical intervention, perhaps due to platelet dysfunction resulting from abnormalities of pluripotent stem cells. Marked splenomegaly (with larger draining veins) is thought to increase the risk of thrombosis.

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