Portal Vein Thrombosis Shown by Ultrasonography

Dw, Walker; Ak, Tonkin; Joly, D

doi:10.1097/00007611-198307000-00030

Cited by 5 publications

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“…Doppler ultrasonography is a non-invasive, inexpensive, repeatable method for detecting PVT [42,43]. Ultrasonography has difficulties in visualizing splenic and superior mesenteric veins [44] and liver cirrhosis may impede adequate penetration of the ultrasounds [45,46]. The introduction of colour techniques, by displaying flow in different colours depending on the direction of the blood, has further implemented ultrasonography.…”

Section: Diagnosismentioning

confidence: 99%

Portal vein thrombosis in liver cirrhosis

2008

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Portal vein thrombosis (PVT) is observed in 10-20% of patients with liver cirrhosis, which is responsible for 20% of all PVT cases. The main pathogenic factor of PVT in cirrhosis is the obstacle to portal flow, but acquired and inherited clotting abnormalities may play a role. The formation of collateral veins allows many patients to remain asymptomatic and prevents the onset of clinical complications also in patients with totally occlusive PVT. Gastrointestinal bleeding, thrombosis of superior mesenteric vein and refractory ascites are typical manifestations of PVT. Instrumental diagnosis can be obtained by colour-doppler ultrasonography. Future studies should verify whether asymptomatic PVT worsens liver failure, or if its life-threatening complications reduce survival in patients with cirrhosis. Moreover, randomized controlled trials should clarify the potential effectiveness of anticoagulant therapy in the treatment of PVT.

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Section: Diagnosismentioning

confidence: 99%

Portal vein thrombosis in liver cirrhosis

2008

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Acute Thrombosis of the Splanchnic Veins

Gertsch¹

1993

Arch Surg

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The consequence of an acute thrombosis in the splanchnic veins on the viability of the intestine has not been well defined in the literature. Spontaneous recovery or total necrosis of the bowel have both been described. We treated seven patients with thrombosis of the splanchnic veins and adopted a surgical approach in three patients with extended and complete thrombosis of the superior mesenteric vein, portal vein, and splenic vein, while four patients with partial thrombosis of the superior mesenteric vein or protal vein recovered with conservative treatment. A 22-year literature review has identified 64 cases of acute thrombosis in the splanchnic veins, with complete information regarding the location and extent of the thrombosis, the treatment, and the outcome. Different anatomical patterns of thrombosis with mortality rates varying between 0% and 76% seem to be related to the extent and completeness of venous obstruction.

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Ultrasonic demonstration of superior mesenteric and splenoportal venous thrombosis

Kidambi

Herbert

Kidambi

1986

J of Clinical Ultrasound

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Diagnosis of major abdominal venous thromboses is difficult.' Correct diagnosis can be made by angiography, computed tomography (CT), or ultras0nography.l-" We report a case in which superior mesenteric venous thrombosis and progressive thrombosis involving the portal and splenic veins were demonstrated by ultrasound. CASE REPORTA 45-year-old male with a previous history of alcohol abuse was admitted with complaints of nausea, epigastric pain, and rigors of short duration. On examination he was febrile (38.3"C oral) with a pulse rate of 100/min. No cardiovascular or lung abnormality was present. On abdominal palpation there was marked tenderness in the epigastrium. No other clinical abnormality was present. Laboratory investigations showed elevated ESR(90 mm at the end of first hour) and leucocytosis (WCC 23.3 x 10g/liter). Hemoglobin was 14.8 g/dl, and serum amylase was 119 IU/liter.Chest and abdominal radiographs showed no abnormality. Real-time ultrasonic examination (Technicare Autosector with a 5.0-MHz transducer) on the day of admission revealed a thrombus in the superior mesenteric vein (Fig. lA,B).The portal and splenic veins were normal. The liver, spleen, and pancreas also appeared normal. On the basis of these findings the patient was heparinized.Within the next week, the patient had gastroscopy and barium meal/follow-through studies, which revealed no abnormality. The patient continued to receive anticoagulant therapy and was rescanned 1 week following admission, when partial resolution of the thrombus was seen ( Fig. 2A,B).Two weeks following admission the patient again complained of severe abdominal pain radiating to the back. There were no significant clinical findings. Serum amylase was slightly elevated at 147 IU/liter. Ultrasonic examination at this stage revealed the presence of thrombi in the portal and splenic veins (Fig. 3A,B) in addition to the superior mesenteric vein.In view of further episodes of abdominal pain and persistent ultrasonic findings, exploratory laparotomy was carried out 3 weeks after admission. This revealed a solid portal vein, an indurated and inflamed pancreas, and some enlarged nodes along the pancreas and in the region of the porta hepatis. One of the parapancreatic nodes was removed. No further surgical procedures were carried out, there being no other visceral abnormality. Histology of the node showed reactive lymphadenitis but no evidence of secondary malignancy.During convalescence the patient developed right calf pain. Venography showed diffise thrombi in the popliteal, distal femoral, and external iliac veins. Anticoagulant therapy was continued. There were no further episodes of abdominal or calf pain. He was discharged on maintenance anticoagulant therapy 5 weeks after admission. At review 1 month later he had no complaints and had gained weight. A t subsequent reviews (6 months and 1 year) he remained well. Ultrasonic examinations on these occasions were unremarkable except for a number of small vascular structures in the region of the porta hepatis suggestiv...

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Portal Vein Thrombosis Shown by Ultrasonography

Cited by 5 publications

References 0 publications

Portal vein thrombosis in liver cirrhosis

Portal vein thrombosis in liver cirrhosis

Acute Thrombosis of the Splanchnic Veins

Ultrasonic demonstration of superior mesenteric and splenoportal venous thrombosis

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