Portal vein thrombosis

Portal vein thrombosis
Portal vein thrombosis seen with computed tomography.
Classification and external resources
Specialty	cardiology
ICD-10	I81
ICD-9-CM	452
eMedicine	radio/571

Portal vein thrombosis, previously known as Cauchois–Eppinger–Frugoni syndrome,^[1] is a form of venous thrombosis affecting the hepatic portal vein, which can lead to portal hypertension and reduction in the blood supply to the liver.

Signs and symptoms

Portal vein thrombosis can cause fever, symptoms of indigestion, and gradually worsening abdominal pain. However, it can also develop without causing symptoms, leading to portal hypertension before it is diagnosed.^[2] Other symptoms can develop based on the cause. For example, if portal vein thrombosis develops due to liver cirrhosis, bleeding or other signs of liver disease may be present. If portal vein thrombosis develops due to pylephlebitis, signs of infection such as fever, chills, night sweats may be present.

Causes

Causes can include pancreatitis, cirrhosis, diverticulitis, and cholangiocarcinoma. It is also a known complication of splenectomy.^[3]

Diagnosis

The diagnosis of portal vein thrombosis is usually made by ultrasound, computed tomography with contrast or magnetic resonance imaging. D-dimer levels in the blood may be elevated as a result of fibrin degradation.

Treatment

Portal vein thrombosis on computed tomography (left) and cavernous transformation of the portal vein after 1 year (right)

Treatments include anticoagulants, shunts, bypass surgery, and transplants.

References

↑ Strous, Rael D.; Edelman, Morris C. (2007). "Eponyms and the Nazi Era: Time to Remember and Time for Change". Israel Medical Association Journal 9: 207–214.
↑ Hall, TC; Garcea, G; Metcalfe, M; Bilku, D; Dennison, AR (November 2011). "Management of acute non-cirrhotic and non-malignant portal vein thrombosis: a systematic review.". World journal of surgery 35 (11): 2510–20. doi:10.1007/s00268-011-1198-0. PMID 21882035.
↑ Ali Cadili, Chris de Gara, "Complications of Splenectomy", The American Journal of Medicine, 2008, pp 371-375.

External links

Wikimedia Commons has media related to Portal vein thrombosis.

Merck

Cardiovascular disease (I70–I99, 440–456)

Arteries, arterioles
and capillaries

Inflammation

Peripheral artery disease

Arteriosclerosis	Atherosclerosis Foam cell Fatty streak Atheroma Intermittent claudication Critical limb ischemia Monckeberg's arteriosclerosis Arteriolosclerosis Hyaline Hyperplastic Cholesterol LDL Oxycholesterol Trans fat

Stenosis	Carotid artery stenosis Renal artery stenosis

Other	Aortoiliac occlusive disease Degos disease Erythromelalgia Fibromuscular dysplasia Raynaud's phenomenon

Aneurysm / dissection /
pseudoaneurysm

Vascular malformation

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Veins

Inflammation	Phlebitis

Venous thrombosis / Thrombophlebitis	primarily lower limb Deep vein thrombosis abdomen Hepatic veno-occlusive disease Budd–Chiari syndrome May–Thurner syndrome Portal vein thrombosis Renal vein thrombosis upper limb / torso Mondor's disease Paget–Schroetter disease head Cerebral venous sinus thrombosis Post-thrombotic syndrome

Varicose veins	Gastric varices Portacaval anastomosis Caput medusae Esophageal varices Hemorrhoid Varicocele

Other	Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer

Arteries or veins

Blood pressure

Hypertension	Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension

Hypotension	Orthostatic hypotension

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