337:
289:
74:
50:
361:) is often initiated and maintained in patients who do not have cirrhosis. Anticoagulation for patients with cirrhosis who experience portal vein thrombosis is usually not advised unless they have chronic PVT 1) with thrombophilia, 2) with clot burden in the mesenteric veins, or 3) inadequate blood supply to the bowels. In more severe instances,
300:
is the least invasive method and the addition of
Doppler technique shows a filling defect in blood flow. PVT may be classified as either occlusive or nonocclusive based on evidence of blood flow around the clot. An alternative characterization based on site can be made: Type 1 is limited to the main
266:
as well as the pancreas, gallbladder, and spleen. Cirrhosis alters bleeding pathways thus patients are simultaneously at risk of uncontrolled bleeding and forming clots. A long-standing hindrance in flow as in chronic PVT, also known as portal cavernoma, can cause an increase in the hepatic venous
231:(HCC), or abdominal surgery/trauma. Red flags for cancerous growth as a cause are elevated alpha fetoprotein levels, portal vein diameter greater than 2.3 cm, pulsatility on Doppler ultrasound imaging, or hyperintense hepatic arterial phase (HAP) on CT scan with contrast.
332:
On duplex ultrasound, demonstration of echogenic material within the portal vein, complete or partial absence of colour flow in the portal vein, presence of collateral vessels around the portal vein or gall bladder that bypass the portal vein.
143:). A persistent fever may result from the generalized inflammation. While abdominal pain may come and go if the thrombus forms suddenly, long-standing clot build-up can also develop without causing symptoms, leading to
789:
774:
301:
portal vein, Type 2 involves only a portal vein branch (2a, or 2b if both branches are affected), and Type 3 if clot is found throughout both areas. Determination of condition severity may be derived via
349:
Treatment is aimed at opening the blocked veins to minimize complications; the duration of clot (acute versus chronic) affects treatment. Unless there are underlying reasons why it would be harmful,
751:
1640:
544:
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".
178:
is unclear, with a wide variety of incidence claimed by various researchers (estimated to be 1 in 100 by some while others believe it affects nearly 1 in 4).
139:
Portal vein thrombosis causes upper abdominal pain, possibly accompanied by nausea and an enlarged liver and/or spleen; the abdomen may be filled with fluid (
274:
An infected thrombus may become septic, known as pylephlebitis; if blood cultures are positive for growth at this time, the most common organism is
369:
may be considered. If blood flow to the gastrointestinal tract has been compromised chronically, surgery may be required to remove dead intestine.
362:
856:
372:
Different considerations are made in the management of PVT in pediatric patients or those who have already received a liver transplant.
1429:
475:
O'Mara SR, Wiesner L. "Hepatic
Disorders". In Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH (eds.).
317:, EGD) to evaluate the presence of concurrent dilated veins (varices) in the stomach or esophagus. Other than perhaps slightly
1201:
17:
1206:
292:
Portal vein thrombosis on computed tomography (left) and cavernous transformation of the portal vein after 1 year (right)
634:
Bacon BR. "Cirrhosis and Its
Complications". In Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J (eds.).
189:
592:"Causes and consequences of portal vein thrombosis in 1,243 patients with cirrhosis: results of a longitudinal study"
1356:
973:
988:
849:
262:(SMV). It is responsible for approximately three-fourths of the liver’s blood flow, transported from much of the
1307:
1119:
150:
Other symptoms can develop based on the cause. For example, if portal vein thrombosis develops due to liver
134:
1424:
1344:
1049:
354:
296:
The diagnosis of portal vein thrombosis is usually made with imaging confirming a clot in the portal vein;
1439:
1434:
1161:
1151:
243:
288:
271:) and increased blood flow through subsidiary veins. This may lead to ascites or bleeding from varices.
1635:
1540:
1191:
1166:
983:
912:
842:
314:
306:
1565:
1508:
1156:
1109:
959:
922:
684:
Friedman LS (2020). "Noncirrhotic Portal
Hypertension". In Papadakis MA, McPhee SJ, Rabow MW (eds.).
154:, bleeding or other signs of liver disease may be present. If portal vein thrombosis develops due to
336:
73:
1550:
1363:
1317:
1312:
1136:
1114:
386:
259:
246:(MPNs) have emerged as a leading systemic cause of splanchnic vein thromboses (which include PVT).
228:
171:
122:
31:
1605:
1587:
1069:
1064:
1028:
998:
263:
235:
201:
192:) is another common cause. Nearly one-third of patients have a myeloproliferative disorder (e.g.
118:
590:
Nery F, Chevret S, Condat B, de
Raucourt E, Boudaoud L, Rautou PE, et al. (February 2015).
1577:
1560:
1555:
1545:
1386:
964:
865:
318:
109:
An equivalent clot in the vasculature that exits the liver carrying deoxygenated blood to the
1582:
1327:
1186:
1178:
1146:
1033:
1496:
1491:
1295:
1087:
8:
1630:
1572:
1339:
793:
302:
268:
144:
99:
95:
1486:
1396:
978:
725:
700:
569:
449:
424:
224:
114:
503:
Simonetto DA, Singal AK, Garcia-Tsao G, Caldwell SH, Ahn J, Kamath PS (January 2020).
1277:
1226:
1126:
730:
666:
613:
561:
526:
454:
193:
91:
62:
822:
798:
1282:
931:
834:
720:
712:
699:
Sacerdoti D, Serianni G, Gaiani S, Bolognesi M, Bombonato G, Gatta A (March 2007).
658:
603:
573:
553:
516:
444:
436:
366:
521:
504:
1474:
1469:
1381:
1104:
1059:
939:
662:
185:
27:
Formation of a blood clot in the hepatic portal vein, reducing blood to the liver
1523:
1373:
1236:
1196:
1131:
1092:
1003:
310:
220:
197:
716:
557:
1624:
1391:
1054:
505:"ACG Clinical Guideline: Disorders of the Hepatic and Mesenteric Circulation"
381:
350:
181:
155:
1218:
783:
158:, signs of infection such as fever, chills, or night sweats may be present.
1532:
1444:
1259:
949:
892:
734:
670:
617:
565:
530:
458:
255:
216:
110:
1597:
993:
276:
239:
212:
766:
49:
1513:
1503:
1464:
1408:
1401:
1231:
297:
608:
591:
440:
1267:
1008:
944:
900:
883:
878:
817:
321:, laboratory tests to evaluate liver function are typically normal.
205:
175:
167:
151:
67:
1481:
1083:
1020:
954:
905:
358:
502:
322:
140:
698:
649:
Cadili A, de Gara C (May 2008). "Complications of splenectomy".
874:
778:
326:
103:
589:
477:
Tintinalli's
Emergency Medicine: A Comprehensive Study Guide
174:
is often implicated. The prevalence of PVT in patients with
1250:
313:(MRA). Those with chronic PVT may undergo upper endoscopy (
90:) is a vascular disease of the liver that occurs when a
30:
Do not confuse portal vein thrombosis (a disorder) with
543:
422:
57:
Portal vein thrombosis seen with computed tomography.
1641:
Diseases of veins, lymphatic vessels and lymph nodes
864:
756:
325:levels in the blood may be elevated as a result of
254:The main portal vein is formed by the union of the
208:are other non-inherited tendencies for thrombosis.
196:or primary thrombocytosis), most commonly due to a
340:Portal vein thrombosis grading after Yerdel et al
1622:
498:
496:
494:
492:
490:
488:
486:
423:DeLeve LD, Valla DC, Garcia-Tsao G (May 2009).
106:. The mortality rate is approximately 1 in 10.
850:
648:
483:
474:
135:Portal hypertension § Signs and symptoms
686:Current Medical Diagnosis and Treatment 2020
100:increased pressure in the portal vein system
585:
583:
1430:Chronic cerebrospinal venous insufficiency
857:
843:
642:
636:Harrison's Principles of Internal Medicine
188:deficiency, protein C or S deficiency, or
72:
48:
724:
638:(20 ed.). New York, NY: McGraw-Hill.
607:
520:
448:
701:"Thrombosis of the portal venous system"
683:
580:
509:The American Journal of Gastroenterology
479:(9 ed.). New York, NY: McGraw-Hill.
335:
287:
184:(including inherited conditions such as
14:
1623:
1202:Hereditary hemorrhagic telangiectasia
838:
128:
1207:Generalized essential telangiectasia
629:
627:
470:
468:
418:
416:
414:
412:
410:
408:
406:
404:
402:
166:Slowed blood flow due to underlying
24:
190:antiphospholipid antibody syndrome
25:
1652:
745:
633:
624:
465:
425:"Vascular disorders of the liver"
399:
242:. During the last several years,
1357:Cerebral venous sinus thrombosis
651:The American Journal of Medicine
307:magnetic resonance imaging (MRI)
102:and reduced blood supply to the
1308:Hepatic veno-occlusive disease
692:
677:
537:
240:surgical removal of the spleen
215:may be injured as a result of
13:
1:
1120:Aneurysm of sinus of Valsalva
974:Monckeberg's arteriosclerosis
522:10.14309/ajg.0000000000000486
392:
1425:Chronic venous insufficiency
1050:Aortoiliac occlusive disease
663:10.1016/j.amjmed.2008.02.014
355:low molecular weight heparin
344:
283:
249:
244:myeloproliferative neoplasms
7:
1440:Inferior vena cava syndrome
1435:Superior vena cava syndrome
1162:Vertebral artery dissection
1152:Intracranial berry aneurysm
375:
10:
1657:
1541:Hypertensive heart disease
1192:Arteriovenous malformation
1167:Familial aortic dissection
315:esophagogastroduodenoscopy
132:
29:
1596:
1566:Renovascular hypertension
1531:
1522:
1509:Hepatic artery thrombosis
1457:
1417:
1372:
1276:
1258:
1249:
1217:
1177:
1157:Carotid artery dissection
1110:Abdominal aortic aneurysm
1082:
1042:
1019:
960:Intermittent claudication
930:
923:Peripheral artery disease
921:
891:
873:
808:
760:
717:10.1016/j.jus.2007.02.007
558:10.1007/s00268-011-1198-0
161:
61:
56:
47:
42:
1551:Hypertensive nephropathy
1364:Post-thrombotic syndrome
1345:Paget–Schroetter disease
1137:Coronary artery aneurysm
1115:Thoracic aortic aneurysm
546:World Journal of Surgery
260:superior mesenteric vein
229:hepatocellular carcinoma
172:congestive heart failure
147:before it is diagnosed.
32:portal vein embolization
1606:Orthostatic hypotension
1588:White coat hypertension
1065:Fibromuscular dysplasia
1029:Carotid artery stenosis
264:gastrointestinal system
119:hepatic vein thrombosis
1578:Pulmonary hypertension
1561:Secondary hypertension
1556:Essential hypertension
1546:Hypertensive emergency
1387:Portacaval anastomosis
1323:Portal vein thrombosis
965:Critical limb ischemia
866:Cardiovascular disease
341:
319:elevated transaminases
293:
200:(JAK2) gene mutation.
84:Portal vein thrombosis
43:Portal vein thrombosis
1583:Systolic hypertension
1328:Renal vein thrombosis
1187:Arteriovenous fistula
1179:Vascular malformation
1147:Intracranial aneurysm
1034:Renal artery stenosis
705:Journal of Ultrasound
339:
291:
18:Portal vein thrombose
1497:Paradoxical embolism
1492:Cholesterol embolism
1318:May–Thurner syndrome
1313:Budd–Chiari syndrome
1296:Deep vein thrombosis
1291:primarily lower limb
1070:Raynaud's phenomenon
387:Budd–Chiari syndrome
305:(CT) with contrast,
234:PVT is also a known
123:Budd-Chiari syndrome
98:, which can lead to
1573:Benign hypertension
303:computed tomography
269:portal hypertension
267:pressure gradient (
211:Alternatively, the
145:portal hypertension
96:hepatic portal vein
1487:Pulmonary embolism
1397:Esophageal varices
1335:upper limb / torso
979:Arteriolosclerosis
809:External resources
342:
294:
225:cholangiocarcinoma
202:Oral contraceptive
129:Signs and symptoms
115:inferior vena cava
1636:Vascular diseases
1618:
1617:
1614:
1613:
1458:Arteries or veins
1453:
1452:
1278:Venous thrombosis
1245:
1244:
1227:Cherry hemangioma
1127:Aortic dissection
1078:
1077:
913:Buerger's disease
832:
831:
609:10.1002/hep.27546
552:(11): 2510–2520.
441:10.1002/hep.22772
194:polycythemia vera
81:
80:
37:Medical condition
16:(Redirected from
1648:
1529:
1528:
1340:Mondor's disease
1283:Thrombophlebitis
1256:
1255:
932:Arteriosclerosis
928:
927:
889:
888:
859:
852:
845:
836:
835:
758:
757:
739:
738:
728:
696:
690:
689:
681:
675:
674:
646:
640:
639:
631:
622:
621:
611:
587:
578:
577:
541:
535:
534:
524:
500:
481:
480:
472:
463:
462:
452:
435:(5): 1729–1764.
420:
77:
76:
52:
40:
39:
21:
1656:
1655:
1651:
1650:
1649:
1647:
1646:
1645:
1621:
1620:
1619:
1610:
1592:
1518:
1475:Microangiopathy
1470:Macroangiopathy
1449:
1413:
1382:Gastric varices
1368:
1281:
1272:
1241:
1213:
1173:
1105:Aortic aneurysm
1091:
1074:
1060:Erythromelalgia
1038:
1015:
940:Atherosclerosis
917:
881:
869:
863:
833:
828:
827:
804:
803:
769:
748:
743:
742:
697:
693:
682:
678:
647:
643:
632:
625:
588:
581:
542:
538:
501:
484:
473:
466:
421:
400:
395:
378:
351:anticoagulation
347:
286:
252:
186:factor V Leiden
164:
137:
131:
71:
38:
35:
28:
23:
22:
15:
12:
11:
5:
1654:
1644:
1643:
1638:
1633:
1616:
1615:
1612:
1611:
1609:
1608:
1602:
1600:
1594:
1593:
1591:
1590:
1585:
1580:
1575:
1570:
1569:
1568:
1558:
1553:
1548:
1543:
1537:
1535:
1526:
1524:Blood pressure
1520:
1519:
1517:
1516:
1511:
1506:
1501:
1500:
1499:
1494:
1489:
1479:
1478:
1477:
1472:
1461:
1459:
1455:
1454:
1451:
1450:
1448:
1447:
1442:
1437:
1432:
1427:
1421:
1419:
1415:
1414:
1412:
1411:
1406:
1405:
1404:
1399:
1394:
1384:
1378:
1376:
1374:Varicose veins
1370:
1369:
1367:
1366:
1361:
1360:
1359:
1349:
1348:
1347:
1342:
1332:
1331:
1330:
1325:
1320:
1315:
1310:
1300:
1299:
1298:
1287:
1285:
1274:
1273:
1271:
1270:
1264:
1262:
1253:
1247:
1246:
1243:
1242:
1240:
1239:
1237:Spider angioma
1234:
1229:
1223:
1221:
1219:Vascular nevus
1215:
1214:
1212:
1211:
1210:
1209:
1204:
1197:Telangiectasia
1194:
1189:
1183:
1181:
1175:
1174:
1172:
1171:
1170:
1169:
1164:
1159:
1154:
1149:
1139:
1134:
1132:Aortic rupture
1129:
1124:
1123:
1122:
1117:
1112:
1097:
1095:
1093:pseudoaneurysm
1080:
1079:
1076:
1075:
1073:
1072:
1067:
1062:
1057:
1052:
1046:
1044:
1040:
1039:
1037:
1036:
1031:
1025:
1023:
1017:
1016:
1014:
1013:
1012:
1011:
1006:
1004:Oxycholesterol
1001:
996:
991:
986:
976:
970:
969:
968:
967:
962:
957:
952:
947:
936:
934:
925:
919:
918:
916:
915:
910:
909:
908:
897:
895:
886:
871:
870:
862:
861:
854:
847:
839:
830:
829:
826:
825:
813:
812:
810:
806:
805:
802:
801:
786:
770:
765:
764:
762:
761:Classification
755:
754:
747:
746:External links
744:
741:
740:
691:
688:. McGraw-Hill.
676:
641:
623:
602:(2): 660–667.
579:
536:
482:
464:
397:
396:
394:
391:
390:
389:
384:
377:
374:
357:, followed by
346:
343:
311:MR angiography
285:
282:
251:
248:
221:diverticulitis
198:Janus kinase 2
163:
160:
130:
127:
117:, is known as
94:occurs in the
79:
78:
65:
59:
58:
54:
53:
45:
44:
36:
34:(a procedure).
26:
9:
6:
4:
3:
2:
1653:
1642:
1639:
1637:
1634:
1632:
1629:
1628:
1626:
1607:
1604:
1603:
1601:
1599:
1595:
1589:
1586:
1584:
1581:
1579:
1576:
1574:
1571:
1567:
1564:
1563:
1562:
1559:
1557:
1554:
1552:
1549:
1547:
1544:
1542:
1539:
1538:
1536:
1534:
1530:
1527:
1525:
1521:
1515:
1512:
1510:
1507:
1505:
1502:
1498:
1495:
1493:
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1488:
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1480:
1476:
1473:
1471:
1468:
1467:
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1462:
1460:
1456:
1446:
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1441:
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1436:
1433:
1431:
1428:
1426:
1423:
1422:
1420:
1416:
1410:
1407:
1403:
1400:
1398:
1395:
1393:
1392:Caput medusae
1390:
1389:
1388:
1385:
1383:
1380:
1379:
1377:
1375:
1371:
1365:
1362:
1358:
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1248:
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1233:
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1216:
1208:
1205:
1203:
1200:
1199:
1198:
1195:
1193:
1190:
1188:
1185:
1184:
1182:
1180:
1176:
1168:
1165:
1163:
1160:
1158:
1155:
1153:
1150:
1148:
1145:
1144:
1143:
1140:
1138:
1135:
1133:
1130:
1128:
1125:
1121:
1118:
1116:
1113:
1111:
1108:
1107:
1106:
1102:
1099:
1098:
1096:
1094:
1089:
1085:
1081:
1071:
1068:
1066:
1063:
1061:
1058:
1056:
1055:Degos disease
1053:
1051:
1048:
1047:
1045:
1041:
1035:
1032:
1030:
1027:
1026:
1024:
1022:
1018:
1010:
1007:
1005:
1002:
1000:
997:
995:
992:
990:
987:
985:
982:
981:
980:
977:
975:
972:
971:
966:
963:
961:
958:
956:
953:
951:
948:
946:
943:
942:
941:
938:
937:
935:
933:
929:
926:
924:
920:
914:
911:
907:
904:
903:
902:
899:
898:
896:
894:
890:
887:
885:
880:
876:
872:
867:
860:
855:
853:
848:
846:
841:
840:
837:
824:
820:
819:
815:
814:
811:
807:
800:
796:
795:
791:
787:
785:
781:
780:
776:
772:
771:
768:
763:
759:
753:
750:
749:
736:
732:
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718:
714:
710:
706:
702:
695:
687:
680:
672:
668:
664:
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652:
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637:
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619:
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551:
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491:
489:
487:
478:
471:
469:
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398:
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385:
383:
382:Pylephlebitis
380:
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182:Thrombophilia
179:
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156:pylephlebitis
153:
148:
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136:
126:
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120:
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55:
51:
46:
41:
33:
19:
1533:Hypertension
1445:Venous ulcer
1351:
1334:
1322:
1302:
1290:
1260:Inflammation
1141:
1100:
989:Hyperplastic
950:Fatty streak
893:Inflammation
816:
788:
773:
711:(1): 12–21.
708:
704:
694:
685:
679:
657:(5): 371–5.
654:
650:
644:
635:
599:
595:
549:
545:
539:
515:(1): 18–40.
512:
508:
476:
432:
428:
371:
348:
331:
295:
275:
273:
256:splenic vein
253:
236:complication
233:
217:pancreatitis
210:
180:
165:
149:
138:
111:right atrium
108:
87:
83:
82:
1598:Hypotension
1142:head / neck
994:Cholesterol
884:capillaries
365:or a liver
329:breakdown.
277:Bacteroides
213:portal vein
1631:Hepatology
1625:Categories
1514:Vasculitis
1504:Thrombosis
1465:Angiopathy
1409:Varicocele
1402:Hemorrhoid
1232:Halo nevus
1088:dissection
879:arterioles
596:Hepatology
429:Hepatology
393:References
367:transplant
298:ultrasound
133:See also:
92:blood clot
1268:Phlebitis
1009:Trans fat
945:Foam cell
901:Arteritis
868:(vessels)
823:radio/571
818:eMedicine
345:Treatment
284:Diagnosis
250:Mechanism
206:pregnancy
176:cirrhosis
168:cirrhosis
152:cirrhosis
68:Angiology
63:Specialty
1482:Embolism
1084:Aneurysm
1021:Stenosis
955:Atheroma
906:Aortitis
875:Arteries
735:23396402
671:18456028
618:25284616
566:21882035
531:31895720
459:19399912
376:See also
359:warfarin
113:via the
1303:abdomen
984:Hyaline
726:3478708
574:7518468
450:6697263
323:D-dimer
204:use or
141:ascites
733:
723:
669:
616:
572:
564:
529:
457:
447:
363:shunts
327:fibrin
162:Causes
70:
1418:Other
1251:Veins
1101:torso
1043:Other
752:Merck
570:S2CID
309:, or
104:liver
1352:head
882:and
794:9-CM
731:PMID
667:PMID
614:PMID
562:PMID
527:PMID
455:PMID
258:and
999:LDL
799:452
790:ICD
784:I81
775:ICD
721:PMC
713:doi
659:doi
655:121
604:doi
554:doi
517:doi
513:115
445:PMC
437:doi
238:of
170:or
121:or
88:PVT
1627::
1103::
1086:/
877:,
821::
797::
782::
779:10
729:.
719:.
709:10
707:.
703:.
665:.
653:.
626:^
612:.
600:61
598:.
594:.
582:^
568:.
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548:.
525:.
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507:.
485:^
467:^
453:.
443:.
433:49
431:.
427:.
401:^
280:.
227:,
223:,
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125:.
1280:/
1090:/
858:e
851:t
844:v
792:-
777:-
767:D
737:.
715::
673:.
661::
620:.
606::
576:.
556::
533:.
519::
461:.
439::
353:(
86:(
20:)
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