Vascular liver disorders (II): Portal vein thrombosis
Portal vein thrombosis (PVT) is a rare disorder that is associated with a variety of underlying conditions, of which liver cirrhosis, malignancy and myeloproliferative disorders are the most common. Based on clinical presentation and results of imaging, two different entities can be identified, acute and chronic PVT. Anticoagulation therapy is recommended for all patients with acute PVT in an attempt to prevent further thrombosis and to promote recanalisation of the obstructed veins. Chronic PVT is characterised by the presence of a portal cavernoma and development of portal hypertension. Bleeding from ruptured oesophageal or gastric varices is the main complication of portal hypertension in these patients. Both endoscopic therapy and β-adrenergic blockade are used for the prevention and treatment of gastrointestinal bleeding. In the absence of bleeding, continuous anticoagulant therapy should be considered for the group of chronic PVT patients in whom an underlying prothrombotic factor can be identified. With adequate management of complications and concurrent diseases, prognosis of PVT is good in patients without underlying cirrhosis or malignancies.
|Keywords||Anticoagulation, Doppler echography, Janus kinase 2, Myeloproliferative disorder, Portal hypertension, Portal vein, Thrombosis, abdominal pain, antibiotic agent, anticoagulant therapy, beta adrenergic receptor blocking agent, blood transfusion, bloody diarrhea, computer assisted tomography, endoscopic sclerotherapy, endoscopic therapy, esophagus varices bleeding, gastrointestinal hemorrhage, gastrointestinal varices bleeding, hepatobiliary system cancer, human, intestine infarction, liver cell carcinoma, liver cirrhosis, liver transplantation, myeloproliferative disorder, nuclear magnetic resonance imaging, percutaneous transluminal angioplasty, portal hypertension, portal vein obstruction, portal vein thrombosis, prognosis, recanalization, review, splenomegaly, surgical thrombectomy, survival rate, thrombophilia, transjugular intrahepatic portosystemic shunt, vasoconstrictor agent|
|Journal||The Netherlands Journal of Medicine|
Hoekstra, J, & Janssen, H.L.A. (2009). Vascular liver disorders (II): Portal vein thrombosis. The Netherlands Journal of Medicine, 46–53. Retrieved from http://hdl.handle.net/1765/15649