PORTAL VEIN THROMBOSIS: ETIOLOGY, DIAGNOSIS AND MANAGEMENT A REVIEW

  • Waseem Raja Dar Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011.
  • Imtiyaz Ahmad Dar Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011.
  • Najeebullah Sofi Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011.
  • Muzamil Latief Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011.
  • Manzoor Ahmad Wani Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011.
  • Prof. Jaswinder Singh Sodhi Department of Internal Medicine, Division Gastroenterology Sheri Kashmir Institute of Medical Sciences, Soura J & K India 190011
Keywords: Portal Vein Thrombosis, Cirrhosis, Anticoagulants, Varices, Portal Hypertension

Abstract

Portal Vein Thrombosis (PVT) is a common clinical problem often found in Gastroenterology Clinics. It may occur with or without pre-existing chronic liver disease. The clinical courses may be acute or chronic. Clinical features vary in acute and chronic Portal Vein Thrombosis. Acute PVT usually presents with a pain abdomen while chronic PVT presents with features of Portal Hypertension. Management also differs—acute PVT is managed with anticoagulants while chronic PVT is managed as portal hypertension.

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References

1. Anand C S, Tandon BN, Nandy S. The causes, management, and outcome of upper gastrointestinal hemorrhage in an Indian hospital. Br J Surg 1983; 70:209-211.
2. Dilawari JB, Chawla Y K. Extrahepatic portal venous obstruction. Gut. 1988; 29:554–5.
3. Poddar U, Thapa BR, Rao KL, Singh K. Etiological spectrum of esophageal varies due to portal hypertension in Indian children: is it different from the West? J Gastroenterol Hepatol. 2008; 23: 1354–7.
4. Schultz S R, LaBerge J M, Gordon RL, et al. Anatomy of the portal vein bifurcation: Intra- versus extrahepatic location: implications for transjugular intrahepatic portosystemic shunts. J VascIntervent. Radiol 1994; 5:457–459.
5. Yamane T, Mori K, Sakamoto K, Ikei S, Akagi Intrahepatic ramification of the portal vein in the right and caudate lobes of the liver. Acta Anat (Basel) 1988; 133:162–172.
6. Baxter E J, Scott L M, Campbell P J, et al Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet 2005; 365: 1054-1061.
7. James C, Ugo V, Le Couedic JP, et al A unique clonal JAK2 mutation leading to constitutive signaling causes polycythaemia vera. Nature 2005; 434: 1144-1148.
8. Kralovics R, Passamonti F, Buser AS et al A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 2005; 352: 1779-1790.
9. Levine RL, Wadleigh M, Cools J, et al Activating mutation in the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and myeloid metaplasia with myelofibrosis. Cancer Cell 2005;7:387-397.
10. Patel RK, Lea NC, Heneghan MA, et al. Prevalence of the activating JAK2 tyrosine kinase mutation V617F in the Budd-Chiari syndrome.
11. Pardanani A D, Levine R L, Lasho T, et al. MPL515 mutations in myeloproliferative and other myeloid disorders: a study of 1182 patients.Blood 2006; 108: 3472-3476.
12. Pikman Y, Lee B H, Mercher T.et al MPLW515L is a novel somatic activating mutation in myelofibrosis with myeloid metaplasia. PLoS Med 2006; 3:e270.
13. Scott L M, Beer P A, Bench A J, Erber W N, Green A R Prevalence of JAK2 V617F and exon 12 mutations in polycythaemia vera. Br J Haematol2007;139:511-51
14. Scott L M, Tong W, Levine R L et al. JAK2 exon 12 mutations in polycythemia vera and idiopathic erythrocytosis. N Engl J Med2007; 356:459-468.
15. E. A. Tsochatzis, M. Senzolo, G. Germani, A. Gatt, and A.K. Burroughs, “Systematic review: portal vein thrombosis in cirrhosis,” Alimentary Pharmacology and Therapeutics, vol. 31, no. 3, pp. 366–374, 2010.
16. A. Tripodi, Q. M. Anstee, K. K. Sogaard, et al., “Hypercoagulability in cirrhosis: causes and consequences,” Journal of Thrombosis and Haemostasis, vol. 9, no. 9, pp. 1715–1723, 2011.
17. Management of Anticoagulation for Portal Vein Thrombosis in Individuals with Cirrhosis: A Systematic Review. Genevi`eve Huard and Marc Bilodeau Hindawi Publishing Corporation International Journal of Hepatology Volume 2012.
18. Janssen H L A, Wijnhoud A, Haagsma E B, Uum S H M, Nieuwkerk C M J, Adang R P, et al. Extrahepatic portal vein thrombosis: aetiology and determinants of survival. Gut. 2001; 49: 720-4.
19. Gürakan F, Eren M, Kocak N, Yüce A, Özen H, Temizel IN, et al. Extrahepatic portal vein thrombosis in children: etiology and long-term follow-up. J Clin Gastroenterol. 2004;38:368-72.
20. Mehrotra RN, Bhatia V, Dabadghao P, Yachha SK. Extrahepatic portal vein obstruction in children: anthropometry, growth hormone, and insulin-like growth factor 1. J Pediatr Gastroenterol Nutr.
21. Bellomo-Brandão MA, Morcillo AM, Hessel G, Cardoso SR, Servidoni M de F, da Costa-Pinto EA. Growth assessment in children with extrahepatic portal vein obstruction and portal hypertension. Arq Gastroenterol. 2003;40:247-50
22. Khuroo MS, Yattoo GN, Zasyar SA, et al. Biliary abnormalities associated with extrahepatic portal venous obstruction. Hepatology 1993; 17: 807–13.
23. Dhiman RK, Puri D, Chawla Y, et al. Biliary changes in extrahepatic portal venous obstruction compression by collaterals or ischemia? GastrointestEndosc 1999; 50:646–52.
24. Tessler FN, Gehring BJ, Gomes AS, et al. Diagnosis of portal vein thrombosis: value of color Doppler imaging. AJR Am J Roentgenol 1991; 157: 293–6.
25. Diagnosis of benign and malignant portal vein thrombosis in cirrhotic patients with hepatocellular carcinoma: color Doppler US, contrast-enhanced US, and fine-needle biopsy. Tarantino L, Francica G, Sordelli I, Esposito F, Giorgio A, Sorrentino P, de Stefano G, Di Sarno A, Ferraioli G, Sperlongano P. Abdom Imaging. 2006 Sep-Oct;31(5):537-44.
26. Portal vein thrombosis: CT features. Lee HK, Park SJ, Yi BH, Yeon EK, Kim JH, Hong HS. Abdom Imaging. 2008 Jan-Feb;33(1):72-9.
27. Accuracy of magnetic resonance imaging for preoperative detection of portal vein thrombosis in liver transplant candidates. Shah TU, Semelka RC, Voultsinos V, Elias J Jr, Altun E, Pamuklar E, Firat Z, Gerber DA, Fair J, Russo MW.
28. Transcatheter Thrombolytic Therapy for Acute Mesenteric and Portal Vein Thrombosis. Michael Hollingshead, Charles T. Burke, Matthew A. Mauro, Susan M. Weeks, Robert G. Dixon, Paul F. Jaques. Journal of Vascular and Interventional Radiology Volume 16, Issue 5, Pages 651-661, May 2005.
29. Systemic thrombolysis of portal vein thrombosis in cirrhotic patients: a pilot study. De Santis A, Moscatelli R, Catalano C, Iannetti A, Gigliotti F, Cristofari F, Trapani S, Attili AF. Dig Liver Dis. 2010 Jun; 42(6):451-5. doi: 10.1016/j.dld.2009.08.009. Epub 2009 Oct 12.
30. M. G. Delgado, S. Seijo, and I. Yepes, “Efficacy and safety of anticoagulation on individuals with cirrhosis and portal vein thrombosis,” Clinical Gastroenterology and Hepatology.
31. C. Francoz, J. Belghiti, V. Vilgrain et al., “Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation,” Gut, vol. 54, no. 5, pp. 691–697, 2005.
How to Cite
1.
Raja Dar W, Dar I, Sofi N, Latief M, Wani MA, Sodhi JS. PORTAL VEIN THROMBOSIS: ETIOLOGY, DIAGNOSIS AND MANAGEMENT A REVIEW. Med. res. chronicles [Internet]. 2015Apr.20 [cited 2024May1];2(2):263-71. Available from: https://medrech.com/index.php/medrech/article/view/81
Issue
Vol. 2 No. 2 (2015): Mar-Apr
Section
Review Article

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