scholarly journals The ABCD of portal vein thrombosis: a systematic approach

2020 ◽  
Vol 53 (6) ◽  
pp. 424-429
Author(s):  
Alexandre Makoto Minoda ◽  
Raissa Brito Fernandes Cadete ◽  
Sara Reis Teixeira ◽  
Valdair Francisco Muglia ◽  
Jorge Elias Junior ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Systematic Approach ◽  
Careful Analysis ◽  
Venous System ◽  
Portal Venous System ◽  
Vein Thrombosis ◽  
Case Files ◽  
Collateral Vessels ◽  
And Diffusion

Abstract Portal vein thrombosis refers to complete or partial obstruction of the portal venous system, in the intrahepatic or extrahepatic venous tract or even in the splenic or superior mesenteric veins. This common and potentially fatal condition can develop in various clinical contexts, especially those of liver cirrhosis, hepatocellular carcinoma, and other solid tumors. Certain characteristics, such as the time since the onset of the thrombus (acute or chronic), its biology (hematic or tumoral), the presence of collateral vessels, and the magnetic resonance imaging aspects, are important components of a thorough, careful analysis, as well as informing decisions regarding the appropriate therapeutic strategy. Here, we present a brief review of the anatomy of the portal venous system and a systematic approach to analyzing the condition, using a mnemonic (ABCD, for age, biology, collaterals, and diffusion). We discuss the various imaging methods and illustrate our discussion with images selected from the case files archived at our facility.

scholarly journals Portal Vein Thrombosis: Diagnosis and Endovascular Management

2021 ◽  
Author(s):  
Connie Ju ◽  
Xin Li ◽  
Sameer Gadani ◽  
Baljendra Kapoor ◽  
Sasan Partovi
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Underlying Disease ◽  
Venous System ◽  
Portal Venous System ◽  
Endovascular Management ◽  
Vein Thrombosis ◽  
Endovascular Interventions ◽  
Clinically Significant ◽  
Optimal Approach

Background Portal vein thrombosis (PVT) is a rare but severe entity that can cause clinically significant sequela such as worsening portal hypertension or mesenteric ischemia. Those cases refractory to medical management may be referred for endovascular intervention. Several technical considerations have been described in the literature, but a cohesive comparison of these multiple techniques is lacking. Methods The purpose of this article is to review the diagnosis and endovascular management of PVT, including areas in which further research is warranted. Results Cases of PVT can be readily diagnosed using ultrasound, computed tomography, or magnetic resonance imaging. Treatment often begins with systemic anticoagulation and endovascular interventions may be used in selected cases. Determining the optimal approach to accessing the portal venous system depends on the underlying disease and chronicity of the thrombus and the degree of occlusion. Once access to the portal venous system is established, catheter-directed therapy may be performed to achieve recanalization. Conclusion Despite the heterogeneity in patient presentation, cases of PVT can be readily diagnosed across several imaging modalities. Strategizing interventional approaches involves evaluation of the underlying disease and the chronicity of the thrombus. Key Points:  Citation Format

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.

scholarly journals Risk Factors Regarding Portal Vein Thrombosis in Chronic Liver Disease

2020 ◽  
Vol 25 (4) ◽  
pp. 38-41
Author(s):  
Liliana Vecerzan ◽  
Romeo Gabriel Mihăilă
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Hepatic Cirrhosis ◽  
Vascular Diseases ◽  
High Rate ◽  
Imaging Method ◽  
Vein Thrombosis ◽  
Common Causes ◽  
Portosystemic Collateral ◽  
Collateral Vessels

Abstract The portal vein thrombosis (PVT) is one of the most frequent vascular diseases of the liver, with a high rate of morbidity and mortality. The most common causes of the PVT are hepatic cirrhosis, hepatobiliary neoplasms, inflammatory and infectious abdominal diseases, and myeloproliferative syndromes.(1,2) The natural progress of the PVT has as a result portal hypertension which leads to splenomegaly and the formation of portosystemic collateral vessels, as well as gastroesophageal, duodenal and jejunal varices. Ultrasonography, especially Doppler ultrasound, is the most widely used imaging method to asses, supervise and diagnose PVT in patients with hepatopathies. The purpose of acute PVT treatment is to re-permeabilize the obstructed vessels; the endoscopic ligature of the varices in the eventuality of their rupture is safe and extremely efficient in chronic PVT. To conclude, PVT is the most common hepatic vascular disorder, and its prevalence has increased particularly among the patients with chronic hepatopathies.(3)

scholarly journals Anomalies of the Portal Venous System in Dogs and Cats as Seen on Multidetector-Row CT: An Overview and Systematization Proposal

2019 ◽  
Author(s):  
Giovanna Bertolini
Keyword(s):  
Portal Vein ◽  
Venous System ◽  
Low Flow ◽  
Portal System ◽  
Multidetector Row Computed Tomography ◽  
Portal Venous System ◽  
Multidetector Row Ct ◽  
Multidetector Row ◽  
Vein Thrombosis ◽  
Portosystemic Shunts

This article offers an overview of congenital and acquired vascular anomalies involving the portal venous system in dogs and cats, as determined by multidetector-row computed tomography angiography. Congenital absence of the portal vein, portal vein hypoplasia, portal vein thrombosis and portal collaterals are described. Portal collaterals are further discussed as high- and low-flow connections, and categorized in hepatic arterioportal malformation, arteriovenous fistula, end-to-side and side-to-side congenital portosystemic shunts, acquired portosystemic shunts, cavoportal and porto-portal collaterals. Knowledge of different portal system anomalies helps understand the underlying physiopathological mechanism and is essential for surgical and interventional approaches.

Chronic Portal Vein Thrombosis: Transcapsular Hepatic Collateral Vessels and Communicating Ectopic Varices

Radiology ◽  
2010 ◽  
Vol 257 (2) ◽  
pp. 568-578 ◽  
Author(s):  
Marcus Seeger ◽  
Rainer Günther ◽  
Holger Hinrichsen ◽  
Marcus Both ◽  
Ulf Helwig ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Ectopic Varices ◽  
Collateral Vessels

scholarly journals Duodeno-Jejunal Varicosities Following Extrahepatic Portal Vein Thrombosis

HPB Surgery ◽  
1992 ◽  
Vol 5 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Nick Varsamidakis ◽  
Brian R. Davidson ◽  
Kenneth Hobbs
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Portal Pressure ◽  
Duodenal Atresia ◽  
Left Lobe ◽  
Jejunal Loop ◽  
Anastomotic Site ◽  
Vein Thrombosis ◽  
Pass Through ◽  
Collateral Vessels

A 31 year old man, under investigation for melena, was found at endoscopy to have varicosities at the site of a duodeno-jejunostomy which had been performed for duodenal atresia when he was three days old. Angiography revealed an occluded portal vein with an extensive collateral circulation. At laparotomy some of the collateral vessels were found to pass through the anastomotic site and directly into the left lobe of the liver. The portal pressure was found to be minimally elevated. Resection of the anastomotic segment was performed with reconstruction using a Roux en Y jejunal loop. Bleeding from collateral vessels passing through an anastomosis site in a patient with extrahepatic portal vein thrombosis has not previously been reported.

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