Portal vein thrombosis: Difference between revisions
(→See Also: equivalent clot in post-hepatic vasculature) |
(→Inciting Causes: Added causes and cross-linked to other WikEM pages) |
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*Abdominal surgery | *Abdominal surgery | ||
*Behçet's syndrome | *Behçet's syndrome | ||
*Cirrhosis | *Cholangiocarcinoma | ||
*[[Cirrhosis]] | |||
*Collagen vascular diseases (eg, lupus) | *Collagen vascular diseases (eg, lupus) | ||
*Compression or invasion of the portal vein by tumor (eg, pancreatic cancer) | *Compression or invasion of the portal vein by tumor (eg, pancreatic cancer) | ||
*[[Diverticulitis]] | |||
*Endoscopic sclerotherapy | *Endoscopic sclerotherapy | ||
*Hepatocellular carcinoma | *[[Hepatocellular carcinoma]] | ||
*[[Inflammatory bowel disease]] | *[[Inflammatory bowel disease]] | ||
*Inherited thrombophilias | *Inherited thrombophilias (e.g. factor V Leiden deficiency, protein C or S deficiency, antiphospholipid antibody syndrome) | ||
*Myeloproliferative syndromes | *Myeloproliferative syndromes (e.g. [[polycythemia vera]] or essential thrombocythemia) | ||
*[[Omphalitis]] | *[[Omphalitis]] | ||
*Oral contraceptives | *Oral contraceptives | ||
| Line 21: | Line 23: | ||
*[[Pregnancy ]] | *[[Pregnancy ]] | ||
*Retroperitoneal fibrosis | *Retroperitoneal fibrosis | ||
*Transjugular intrahepatic portosystemic shunt | *[[Splenectomy]] complication | ||
*[[Transjugular intrahepatic portosystemic shunt]] (TIPS) | |||
*[[Trauma]] | *[[Trauma]] | ||
Revision as of 01:27, 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
- Cholangiocarcinoma
- Cirrhosis
- Collagen vascular diseases (eg, lupus)
- Compression or invasion of the portal vein by tumor (eg, pancreatic cancer)
- Diverticulitis
- Endoscopic sclerotherapy
- Hepatocellular carcinoma
- Inflammatory bowel disease
- Inherited thrombophilias (e.g. factor V Leiden deficiency, protein C or S deficiency, antiphospholipid antibody syndrome)
- Myeloproliferative syndromes (e.g. polycythemia vera or essential thrombocythemia)
- Omphalitis
- Oral contraceptives
- Pancreatic islet cell transplantation
- Pancreatitis
- Paroxysmal nocturnal hemoglobinuria
- Pregnancy
- Retroperitoneal fibrosis
- Splenectomy complication
- Transjugular intrahepatic portosystemic shunt (TIPS)
- 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
Management
Disposition
See Also
Budd-Chiari syndrome (hepatic vein thrombosis)