scholarly journals Duplex doppler sonography in portal hypertension

2007 ◽  
Vol 60 (3-4) ◽  
pp. 161-167 ◽  
Author(s):  
Dijana Niciforovic ◽  
Viktor Till ◽  
Dusan Hadnadjev ◽  
Mira Govorcin ◽  
Zorka Lucic ◽  
...  
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Doppler Ultrasonography ◽  
Doppler Sonography ◽  
Imaging Modality ◽  
Vein Thrombosis ◽  
Duplex Doppler ◽  
Duplex Doppler Sonography

Conventional echotomography and duplex Doppler ultrasonography are noninvasive imaging techniques in measurement of hepatic blood flow. In the period from February 2002 to March 2004, 29.086 patients underwent ultrasound examination at the Institute of Radiology in Novi Sad, and 17.503 presented with symptoms of gastroenterology diseases and/or hepatobiliary tract diseases. 984 patients underwent duplex Doppler sonography. This prospective study included 50 patients with suspected or confirmed diagnosis of portal hypertension. All patients were examined using Siemens Versa Pro (3.5 MHz convex probe; B-mode, color and pulse Doppler). The following parameters were evaluated: Doppler sonoscore, congestion index and portal vein thrombosis. By analyzing gathered data, the diagnosis of portal hypertension was confirmed in 10% of patients at baseline, and in 6% of patients at last follow-up, six months later. Results of this investigation demonstrate the importance of duplex Doppler ultrasonography as an excellent noninvasive diagnostic method used for visualization of the direction and velocity of blood flow, as well as presence of portal vein thrombosis. This imaging modality is used as an initial diagnostic tool in the evaluation of the portohepatic circulation, especially in portal hypertension syndrome and in suspected portal vein thrombosis. .

Clinical case of chronic portal vein thrombosis

2020 ◽  
pp. 27-41
Author(s):  
L. Zaklyakova ◽  
B. Levitan ◽  
M. Bolgova ◽  
V. Skvortsov ◽  
I. Zaklyakov
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Oral Anticoagulant ◽  
Clinical Case ◽  
Standard Treatment ◽  
Decompensated Cirrhosis ◽  
Mechanical Trauma ◽  
Vein Thrombosis

Portal vein thrombosis (PVT) is a form of venous thrombosis that causes impaired or terminated blood flow in the portal vein. PVT is the main reason for the development of extrahepatic portal hypertension. The article presents a clinical case of chronic PVT with signs of severe portal hypertension and ascites. A feature of the case is that in a patient with suspected decompensated cirrhosis of the liver with the ineffectiveness of standard treatment, PVT was detected. The cause of PVT was mechanical trauma of the portal vein and hemocoagulation thrombophilia. For health reasons, the patient was prescribed rivaroxaban. Rivaroxaban is an oral anticoagulant from the group of Xa inhibitors. Against the background of treatment, recanalization of PVT was noted in the patient. Our experiment has shown that rivaroxaban is a promising drug for treatment of PVT.

scholarly journals MesoTIPS: Combined Approach for the Treatment of Portal Hypertension Secondary to Portal Vein Thrombosis – A Brief Report

2017 ◽  
Vol 01 (01) ◽  
pp. 20-26
Author(s):  
Abbas Chamsuddin ◽  
Lama Nazzal ◽  
Thomas Heffron ◽  
Osama Gaber ◽  
Raja Achou ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Vein Thrombosis ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right ◽  
Minilaparotomy Approach ◽  
Mean Time

AbstractIntroduction: We describe a technique we call “Meso-transjugular intrahepatic portosystemic shunt (MTIPS)” for relief of portal hypertension secondary to portal vein thrombosis (PVT) using combined surgical and endovascular technique. Materials and Methods: Nine adult patients with PVT underwent transjugular intrahepatic portosystemic shunt through a combined transjugular and mesenteric approach (MTIPS), in which a peripheral mesenteric vein was exposed through a minilaparotomy approach. The right hepatic vein was accessed through a transjugular approach. Mechanical thrombectomy, thrombolysis, and angioplasty were performed when feasible to clear PVT. Results: All patients had technically successful procedures. Patients were followed up for a mean time of 13.3 months (range: 8 days to 3 years). All patients are still alive and asymptomatic. Conclusion: We conclude that MTIPS is effective for the relief of portal hypertension secondary to PVT.

Development of Portal Vein Thrombosis Complicating Idiopathic Portal Hypertension

1985 ◽  
Vol 88 (4) ◽  
pp. 1034-1040 ◽  
Author(s):  
Kunihiko Ohnishi ◽  
Masayuki Saito ◽  
Hidetaka Terabayashi ◽  
Fumio Nomura ◽  
Kunio Okuda
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Idiopathic Portal Hypertension ◽  
Vein Thrombosis

Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial

Gut ◽  
2017 ◽  
Vol 67 (12) ◽  
pp. 2156-2168 ◽  
Author(s):  
Yong Lv ◽  
Xingshun Qi ◽  
Chuangye He ◽  
Zhengyu Wang ◽  
Zhanxin Yin ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Adverse Events ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Decompensated Cirrhosis ◽  
Covered Stents ◽  
Band Ligation ◽  
Vein Thrombosis ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation

ObjectiveLimited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT.DesignConsecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively. Primary endpoint was variceal rebleeding. Secondary endpoints included survival, overt hepatic encephalopathy (OHE), portal vein recanalisation and rethrombosis, other complications of portal hypertension and adverse events.ResultsDuring a median follow-up of 30 months in both groups, variceal rebleeding was significantly less frequent in the TIPS group (15% vs 45% at 1 year and 25% vs 50% at 2 years, respectively; HR=0.28, 95% CI 0.10 to 0.76, p=0.008), with a significantly higher portal vein recanalisation rate (95% vs 70%; p=0.03) and a relatively lower rethrombosis rate (5% vs 33%; p=0.06) compared with the EBL+drug group. There were no statistically significant differences in survival (67% vs 84%; p=0.152), OHE (25% vs 16%; p=0.440), other complications of portal hypertension and adverse events between groups.ConclusionCovered TIPS placement in patients with PVT and moderately decompensated cirrhosis was more effective than EBL combined with propranolol for the prevention of rebleeding, with a higher probability of PVT resolution without increasing the risk of OHE and adverse effects, but this benefit did not translate into improved survival.Trial registration numberClinicalTrials.gov: NCT01326949.

scholarly journals Difficulties of differential diagnosis of portal hypertension: case report

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. 

scholarly journals A226 INCIDENTAL FINDING OF A LARGE GASTRIC VARIX ASSOCIATED WITH NEONATAL UMBILICAL VEIN CANALIZATION

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 261-263
Author(s):  
L Tsang ◽  
J Abraldes ◽  
E Wiebe ◽  
G S Sandha ◽  
S van Zanten
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Umbilical Vein ◽  
Gastroesophageal Junction ◽  
Splenic Vein ◽  
Gastric Varix ◽  
Vein Thrombosis ◽  
Inferior Aspect ◽  
Upper Abdomen

Abstract Results A 41-year old Asian male, who immigrated to Canada many years ago, and who had previously been successfully treated for Helicobacter pylori infection underwent gastroscopy for investigation of dyspepsia. His gastroscopy was normal except for a large subepithelial abnormality that was noted close to the gastroesophageal junction. Routine gastric biopsies from the antrum and body were normal. Subsequent endoscopic ultrasound revealed flow through the anechoic tortuous lesion and confirmed it was a very large isolated gastric varix type 1. Abdominal CT scan revealed chronic occlusion of the portal vein, splenic vein, and the portal confluence with extensive collateralization in the upper abdomen. There was complete cavernous transformation of the portal vein. Of the numerous varices in the upper abdomen, a very large varix drained into the left renal vein and indented into the posterior wall of the fundus of the stomach which accounted for the endoscopic finding. Multiple mesenteric veins were identified that connected to varices adjacent to the inferior aspect of the pancreas and duodenum. Notably, there was no evidence of cirrhosis or chronic pancreatitis. Liver enzymes, albumin, and INR were normal. Further collateral history revealed that he was hospitalized as a neonate for pneumonia with catheterization of the umbilical vein, which is known to be associated with thrombosis of the portal vein. Conclusions Detection of congenital absence of the portal vein (CAPV) is recognized more often due to advances in diagnostic imaging. Radiologically, the absence of the portal vein in CAPV is distinguished from portal vein thrombosis by the lack of venous collaterals or sequalae of portal hypertension, such as ascites or splenomegaly. A more gradual thrombosis of the portal vein may permit collaterals to develop without acute changes and is not equivalent to portal vein aplasia or agenesis as intrahepatic bile ducts are normal. The gold standard for diagnosis of CAPV is histologic absence of the portal vein in the liver on catheter angiography. CAPV is associated with abnormal embryologic development of the portal vein and frequently presents with complications of portal hypertension or portosystemic encephalopathy or the sequalae of venous shunts, hepatic or cardiac abnormalities found on imaging. Our case is an incidentally discovered absence of the portal venous system due to chronic thrombosis with extensive collateralization and an enlarged gastric varix protruding into the proximal stomach. It is well documented that canalization of the umbilical vein in infancy is associated with portal vein thrombosis, with incidences up to 68%. This case highlights the importance of eliciting a childhood hospitalization history in cases of non-cirrhotic portal hypertension. Funding Agencies None

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