Download PDF. 1 / 3 Pages. Previous article. Go back to website. Next article. HARRIS D., Paul BRINCK M., Patricio. Un análisis retrospectivo de cavernomatosis de la vena porta en Chile: II. Hemorragia, tratamiento y pronóstico. Rev. chil. HARRIS D., Paul BRINCK M., Patricio. Un análisis retrospectivo de cavernomatosis de la vena porta en Chile.: I. Perfil clínico y de laboratorio. Rev. chil. pediatr.

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Other modalities of treatment should be adopted only in case of partial or absent PVT resolution[ 12].

Meta-analysis of the risk of venous thrombosis in individuals with antiphospholipid antibodies without underlying autoimmune disease or previous thrombosis.

Inherited prothrombotic defects in Budd-Chiari syndrome and portal vein thrombosis: They are more frequent after an episode of gastrointestinal bleeding or associated with renal failure or sepsis in older patients[ 86467 ]. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Finally, the role of oral contraceptives, steroids, and pregnancy is still less clear[ 45 – 47 ].

Sherlock S, Dooley J.

Surgical thrombectomy is usually cavernoka recommended, as high morbidity and mortality have been reported; percutaneous transhepatic mechanical thrombectomy might also be effective in recent thrombosis, but vascular traumas are frequent and may stimulate rethrombosis[ ]. The history of PVT has been characterized by difficulties in diagnosis and treatment, which, today, have almost been overcome.

Extrahepatic portal vein thrombosis. Changing perspectives in portal vein thrombosis and liver transplantation. In contrast, when thrombosis spreads to mesenteric venous arches, the consequence is intestinal ischemia or infarction. This mild, transient, ascites is due to intestinal venous congestion in the absence of the mechanisms activated in liver cirrhosis[ 6364 ].

Portal vein thrombosis; risk factors, clinical presentation and treatment. Complete thrombosis of portal vein and pkrta and distal superior mesenteric vein. However, among patients with PVT, survival seems better in low grades of Yerdel classification; however, further studies are needed to confirm this data.

Observations in ten patients. However, efficacy is significantly lower and mortality increased in patients who undergo thrombolysis, if compared to conservative treatment[ 59, ].


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Thrombolytic therapy, given either into the systemic al circulation, the superior mesenteric artery, or the portal vein via a transjugular or transhepatic route, is also effective to provide recanalization in acute PVT[ – ]. Current state of portosystemic shunt surgery.

Doppler imaging can confirm the absence of flow in part or all the vasal lumen, and, if present, a cavernomatous venna 22 ]. Cause of portal or hepatic venous thrombosis in adults: In contrast, other studies consider anticardiolipin antibodies simply as an epiphenomenon of liver damage[ 4144 ].

Currently, thanks to great innovations in medical care, surgical techniques, and radiological interventions, this belief has been confounded and PVT by itself can represent an indication for liver transplantation[ 1164, ].

Thrombotic risk factors in ven with liver cirrhosis: In contrast, a distal spleno-renal shunt or an H-type meso-caval shunt, in the same condition, didnot seem to be equally effective, probably due to insufficient residual portal vein flow and the consequent impairment in liver synthetic function[ 29 ].

Incidentally, a pragmatic approach, such as endoscopical eradication of varices prior to cavdrnoma of anticoagulation, should be reasonable[ 79 ].

Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

Inflammatory abdominal foci such as appendicitis, diverticulitis, inflammatory bowel diseases, pancreatitis, cholecystitis, hepatic abscesses, and cholangitisliver cirrhosis or tumors, represent the most common local thrombotic risk factors[ 81218 ]. Anticoagulation in acute PVT Although PVT might be compared to other cases of deep vein thrombosis, there is no randomized controlled trial regarding the use of anticoagulants in acute PVT[ ].

Portal vein thrombosis in hepatocellular carcinoma: Table 3 Prevalence of thrombotic risk factors in series of routinely investigated, consecutive adult patients with non tumorous and non cirrhotic, acute or chronic, PVT[ ].

Clinical features, diagnosis and outcome of acute portal vein thrombosis. Gradient-echo MR might help to better evaluate any confusing spin-echo MR image[ 80 ]. Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation. Ultrasound-guided fine needle aspiration biopsy of portal vein thrombosis in liver cirrhosis: Portal vein thrombosis in children and adolescents.


The ubiquitous and long-term use of anticoagulants in cirrhotic patients with PVT should not be considered correct practice, until their caveenoma and efficacy has been completely tested[ 62 ]. CT scanning is able to demonstrate hyperattenuating material in the portal vein lumen and the absence of enhancement after contrast injection.

Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

Table 5 Intraoperatory grading of PVT extension[ 17 ]. It has been demonstrated in rats, that the progressive obliteration of the portal vein stimulates apoptosis of hepatocytes in the hypoperfused lobe[ 10 ], while increasing the mitotic activity in the normal perfused one.

Surg Laparosc Endosc Percutan Tech. Acknowledgments We give special thanks to Fondazione Ricerca in Medicina. On the cessation of portal blood flow, the liver loses about two thirds of its blood supply. MRI might ccavernoma confirm the vascular occlusion; at spin-echo MR, the clot appears isointense on T1- weighted images, or hyperintense if recent, and usually has a more intense signal on T2 images.

Common radiological findings lz the thinning of the intestinal wall and the presence of defects of enhancement after intravenous contrast injection[ 8 ]. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis.

Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures.

Malformación cavernomatosa de la vena porta

It seems to be effective in resolving portal biliopathy, ascites, and portal cavernoa, but it is not feasible if portal vein is not catheterizable or a cavernomatous vein cannot be dilated[ – ]. It appears to be more accurate than US or computed tomography CT scans in discovering portal invasion by tumors[ 7778 ]. If acute PVT is suspected, computed tomography CT scan, before and after injection of vascular contrast agent, should be obtained for early confirmation of diagnosis.