Abstract
Portal vein thrombosis (PVT) is increasingly recognized in patients with cirrhosis due to the routine use of accurate noninvasive imaging studies, including Doppler ultrasound, computed tomography, and magnetic resonance imaging, for the detection and diagnosis of complications of end-stage liver disease. Possible risk factors for PVT in patients with cirrhosis include advanced liver disease, underlying thrombophilia, slowing of portal venous blood flow, and previous surgical or endoscopic treatment for portal hypertension. Possible consequences of PVT in patients with cirrhosis include progression of liver disease, ascites, refractory gastrointestinal bleeding, losing veins that can be used for providing portal venous inflow to the liver allograft, and decreased survival after liver transplantation. Differentiating PVT from malignant invasion by hepatocellular carcinoma is crucial but now facilitated by contrast-enhanced imaging. Treatment recommendations are based on limited data. Although placement of a transjugular intrahepatic portosystemic shunt and anticoagulation therapy appear to be feasible in many patients without an obviously increased risk of complications, the impact of these interventions on outcome is still unclear. Promising preliminary results using anticoagulation to prevent PVT and liver disease progression require confirmation.
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Valla, DC. (2015). Portal Vein Thrombosis. In: Keaveny, A., Cárdenas, A. (eds) Complications of Cirrhosis. Springer, Cham. https://doi.org/10.1007/978-3-319-13614-1_20
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DOI: https://doi.org/10.1007/978-3-319-13614-1_20
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