Portal vein thrombosis: Difference between revisions
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==Background== | ==Background== | ||
Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, leading to increased pressure in the portal vein system and reduced blood supply to the liver. | |||
===Inciting Causes=== | ===Inciting Causes=== | ||
Revision as of 01:13, 24 April 2020
Background
Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, leading to increased pressure in the portal vein system and reduced blood supply to the liver.
Inciting Causes
- Abdominal sepsis
- Abdominal surgery
- Behçet's syndrome
- Cirrhosis
- Collagen vascular diseases (eg, lupus)
- Compression or invasion of the portal vein by tumor (eg, pancreatic cancer)
- Endoscopic sclerotherapy
- Hepatocellular carcinoma
- Inflammatory bowel disease
- Inherited thrombophilias
- Myeloproliferative syndromes
- Omphalitis
- Oral contraceptives
- Pancreatic islet cell transplantation
- Pancreatitis
- Paroxysmal nocturnal hemoglobinuria
- Pregnancy
- Retroperitoneal fibrosis
- Transjugular intrahepatic portosystemic shunt
- Trauma
Clinical Features
Acute
- Upper abdominal pain developing suddenly or progressing over a few days
- Possibly accompanied by nausea, hepatomegaly, splenomegaly; may be accompanied by persistent non-spiking fever in the setting of systemic inflammation
- Other signs/symptoms based on underlying cause (e.g. bleeding disorders, hepatic stigmata if due to cirrhosis)
Chronic
- May be clinically silent in a portion of patients and diagnosed incidentally during a CT exam for other reasons (e.g. acute pancreatitis)
- Associated with portal hypertension
Differential Diagnosis
Evaluation
- Typically diagnosed on abdominal CT with contrast