Portal vein thrombosis natural history, complications and prognosis
|
Portal vein thrombosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Portal vein thrombosis natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Portal vein thrombosis natural history, complications and prognosis |
|
FDA on Portal vein thrombosis natural history, complications and prognosis |
|
CDC on Portal vein thrombosis natural history, complications and prognosis |
|
Portal vein thrombosis natural history, complications and prognosis in the news |
|
Blogs on Portal vein thrombosis natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
If left untreated, patients with portal vein thrombosis may progress to develop portal cavernoma, gastric or esophageal varices/bleeding, hepatic encephalopathy, splenomegaly, portal biliopathy, and cholangiopathy. Depending on the extent of the model for end-stage liver disease score at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.
Natural History, Complications, and Prognosis
Natural History
- There is usually subclinical prothrombotic state in about in about 72% of idiopathic portal vein thrombosis.
- If left untreated, patients with portal vein thrombosis may progress to develop portal cavernoma, gastric or esophageal varices/bleeding, hepatic encephalopathy, splenomegaly, portal biliopathy, and cholangiopathy.[1]
Complications
- Common complications of portal vein thrombosis include:[2][3][4][5][6]
- Portal cavernoma
- Gastric or esophageal varices/bleeding
- Hepatic encephalopathy
- Portal biliopathy or cholangiopathy
- Thrombocytopenia
- Splenomegaly
- Ascites
- Peritonitis
- Hypoxia
- Pulmonary artery hypertension
- Portal hypertensive gastropathy
Prognosis
- The 1 year mortality rate of patients with chronic portal vein thrombosis is approximately 80%-95% and the 3 year mortality rate of patients with chronic portal vein thrombosis is approximately 75%-90%.[7][8][9]
- Mortality in patients with cancer or cirrhosis in one year is 26% and those without cancer or cirrhosis is 8%.[3]
- Depending on the extent of the model for end-stage liver disease score at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[10]
- Morbidity and mortality is associated with following factors:[7]
- Increasing age
- Recurrent thrombosis
- Portal cholangiopathy
- Progression of the underlying myeloproliferative disease or its transformation into acute leukemia
References
- ↑ Chawla YK, Bodh V (2015). "Portal vein thrombosis". J Clin Exp Hepatol. 5 (1): 22–40. doi:10.1016/j.jceh.2014.12.008. PMC 4415192. PMID 25941431.
- ↑ Trebicka J, Strassburg CP (2014). "Etiology and Complications of Portal Vein Thrombosis". Viszeralmedizin. 30 (6): 375–80. doi:10.1159/000369987. PMC 4513836. PMID 26288604.
- ↑ 3.0 3.1 Condat B, Pessione F, Hillaire S, Denninger MH, Guillin MC, Poliquin M, Hadengue A, Erlinger S, Valla D (2001). "Current outcome of portal vein thrombosis in adults: risk and benefit of anticoagulant therapy". Gastroenterology. 120 (2): 490–7. PMID 11159889.
- ↑ Garcia-Pagán JC, Hernández-Guerra M, Bosch J (2008). "Extrahepatic portal vein thrombosis". Semin. Liver Dis. 28 (3): 282–92. doi:10.1055/s-0028-1085096. PMID 18814081.
- ↑ Condat B, Vilgrain V, Asselah T, O'Toole D, Rufat P, Zappa M, Moreau R, Valla D (2003). "Portal cavernoma-associated cholangiopathy: a clinical and MR cholangiography coupled with MR portography imaging study". Hepatology. 37 (6): 1302–8. doi:10.1053/jhep.2003.50232. PMID 12774008.
- ↑ Dhiman RK, Behera A, Chawla YK, Dilawari JB, Suri S (2007). "Portal hypertensive biliopathy". Gut. 56 (7): 1001–8. doi:10.1136/gut.2006.103606. PMC 1994341. PMID 17170017.
- ↑ 7.0 7.1 Parikh, Sameer; Shah, Riddhi; Kapoor, Prashant (2010). "Portal Vein Thrombosis". The American Journal of Medicine. 123 (2): 111–119. doi:10.1016/j.amjmed.2009.05.023. ISSN 0002-9343.
- ↑ Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H (2007). "Portal vein thrombosis; risk factors, clinical presentation and treatment". BMC Gastroenterol. 7: 34. doi:10.1186/1471-230X-7-34. PMC 1976099. PMID 17697371.
- ↑ Amitrano L, Guardascione MA, Scaglione M, Pezzullo L, Sangiuliano N, Armellino MF, Manguso F, Margaglione M, Ames PR, Iannaccone L, Grandone E, Romano L, Balzano A (2007). "Prognostic factors in noncirrhotic patients with splanchnic vein thromboses". Am. J. Gastroenterol. 102 (11): 2464–70. doi:10.1111/j.1572-0241.2007.01477.x. PMID 17958760.
- ↑ Janssen HL, Wijnhoud A, Haagsma EB, van Uum SH, van Nieuwkerk CM, Adang RP, Chamuleau RA, van Hattum J, Vleggaar FP, Hansen BE, Rosendaal FR, van Hoek B (2001). "Extrahepatic portal vein thrombosis: aetiology and determinants of survival". Gut. 49 (5): 720–4. PMC 1728504. PMID 11600478.