Also Known As:

What is Portal Vein Thrombosis?

Thrombosis is a general term describing the condition that occurs when a blood clot develops within a blood vessel, causing the blood flow to be restricted or completely stopped.

Portal Vein Thrombosis is a type of Venous Thrombosis, that occurs when a blood clot forms in the portal vein. The portal vein carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver.

Portal Vein Thrombosis can develop into a serious condition called Portal Hypertension. This is an increase in blood pressure in the hepatic portal system, causing the spleen to enlarge (Splenomegaly), and creating varices in the oesophagus and in the stomach, which can bleed profusely.

Causes

Virchow’s Triad (or the Triad of Virchow), describes the three broad categories that are thought to contribute to Thrombosis:
•   Hypercoagulability: Abnormalities in blood coagulation, fibrinolytic pathways and in platelet function
•   Vascular Wall Injury/Dysfunction: Injuries and/or trauma to the interior lining of blood vessels
•   Circulatory Stasis: The slowing or stopping of blood flow

Factors that can increase the risk of developing Portal Vein Thrombosis include:
•   Inflammation of the pancreas
•   Appendicitis
•   Naval infection from the umbilical cord stump in newborns
•   Cirrhosis of the liver
•   Liver diseases
•   Injury or Surgery
•   Birth control pills or hormone replacement therapy
•   Cancer and cancer treatment
•   Blood-clotting disorders
•   Pregnancy
•   Inflammatory Bowel Disease

Symptoms

Portal Vein Thrombosis has very few symptoms. Many people do not realise they have the condition until after they’ve developed Portal Hypertension.

The symptoms Portal Vein Thrombosis may include:
•   Upper abdominal pain
•   Abdominal swelling from excess abdominal fluid
•   Fever
•   Liver pain
•   Vomiting blood
•   Yellowing of the skin, or jaundice
•   Varices and gastric bleeding

Diagnosis & Treatment

Portal Vein Thrombosis is diagnosed by a Doctor using a physical examination, blood tests and scans. The Doctor may also order the following tests:
•   Ultrasound Scan
•   MRI Scan
•   CT Scan
•   Liver Function Tests (LFT)
•   Angiogram
•   Endoscopy

The exact treatment used will be determined by the underlying condition, as well as any associated complications. Treatments may include:
•   Anticoagulant Medications
•   Thrombolytic Medications
•   Beta Blockers
•   Octreotide Medications
•   Endoscopic Band Ligation (EBL)
•   Transjugular Intrahepatic Portosystemic Shunt (TIPSS)
•   Meso-Rex Bypass (MRB)
•   Liver Transplant

If a person notices any symptoms of Portal Vein Thrombosis, it is crucial to seek immediate medical attention, because severe life-threatening complications can occur.

Additional Information

The portal vein is not a true vein, because it delivers blood to capillary beds in the liver and not directly back to the heart. Approximately 75 percent of total liver blood flow is through the portal vein, with the remainder coming from the hepatic arteries. The blood leaves the liver to the heart in the hepatic veins.

Also see: Thrombosis, Portal Hypertension