eMedicine Specialties > Radiology > Gastrointestinal

Portal Vein Thrombosis: Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist and Honorary Professor, North Manchester General Hospital Pennine Acute NHS Trust, UK
Coauthor(s): Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute; Aali J Sheen, MD, MBChB, FRCS, Consulting Hepatobiliary Surgeon, HepatoBiliary Unit, Manchester Royal Infirmary; Chi-Leung (Eddie) Tam, MB, ChB, FRCS, Consulting Staff, Department of Radiology, Lancaster Royal Infirmary, UK; David Sherlock, MBBS, FRCS, Consulting Staff, Department of Surgery, North Manchester General Hospital, Christie Hospital; Yousif Al-Khattab, MBChB, DMRD, FRCR, Consulting Staff, Department of Radiology, North Manchester Healthcare Trust, UK
Contributor Information and Disclosures

Updated: Oct 1, 2009

Intervention

The development of PVT can precipitate the need for emergency endoscopy for sclerotherapy of varices, transjugular intrahepatic portosystemic shunt (TIPS) creation, surgical portocaval shunt creation, transjugular or transhepatic portomesenteric thrombolysis and thrombectomy, or even resection of ischemic bowel or liver transplantation.40 However, PVT may complicate sclerotherapy. Fine-needle aspiration biopsy of PVT can be performed with color Doppler sonographic guidance to assess therapeutic effectiveness.

Early complications of TIPS creation that are detectable with ultrasonography include the following: intraperitoneal hemorrhage, shunt thrombosis, neck hematoma, compromise of hepatic blood supply, PVT, hepatic artery occlusion, hepatic infarction, failed stent deployment, inadequate stent expansion, stent retraction, stent fracture, and biliary obstruction.41,42,43

Delayed complications of TIPS creation that are detectable with ultrasonography include shunt stenosis caused by pseudointimal hyperplasia and hepatic vein stenosis.44,45

Medicolegal Pitfalls

  • With PVT, patients are sick, and most percutaneous procedures are associated with high risk.46,47
  • This concern must be explained to the patients and/or their guardians.
 


More on Portal Vein Thrombosis

Overview: Portal Vein Thrombosis
Imaging: Portal Vein Thrombosis
Follow-up: Portal Vein Thrombosis
Multimedia: Portal Vein Thrombosis
References
Further Reading
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References

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Keywords

PVT, portal venous thrombosis, transient portal vein thrombosis, cavernous transformation of the portal vein, splenic vein thrombosis, angina, pseudocholangiocarcinoma, pancreatitis, thrombophlebitis, transjugular intrahepatic portosystemic shunt, TIPS

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist and Honorary Professor, North Manchester General Hospital Pennine Acute NHS Trust, UK
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, British Medical Association, British Society of Interventional Radiology, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Aali J Sheen, MD, MBChB, FRCS, Consulting Hepatobiliary Surgeon, HepatoBiliary Unit, Manchester Royal Infirmary
Aali J Sheen, MD, MBChB, FRCS is a member of the following medical societies: British Medical Association, International Hepato-Pancreato-Biliary Association, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Chi-Leung (Eddie) Tam, MB, ChB, FRCS, Consulting Staff, Department of Radiology, Lancaster Royal Infirmary, UK
Chi-Leung (Eddie) Tam, MB is a member of the following medical societies: Royal College of Radiologists
Disclosure: Nothing to disclose.

David Sherlock, MBBS, FRCS, Consulting Staff, Department of Surgery, North Manchester General Hospital, Christie Hospital
Disclosure: Nothing to disclose.

Yousif Al-Khattab, MBChB, DMRD, FRCR, Consulting Staff, Department of Radiology, North Manchester Healthcare Trust, UK
Disclosure: Nothing to disclose.

Medical Editor

Eric P Weinberg, MD, Associate Professor, Department of Radiology, University of Rochester Medical Center, Strong Memorial Hospital
Eric P Weinberg, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Arnold C Friedman, MD, FACR, Associate Chairman, Department of Radiology, University of Florida Health Science Center; Chief, Department of Radiology, Shands-Jacksonville Hospital
Arnold C Friedman, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Kyung J Cho, MD, FACR, William Martel Professor of Radiology, Interventional Radiology Fellowship Director, University of Michigan Health System
Kyung J Cho, MD, FACR is a member of the following medical societies: American College of Radiology, American Heart Association, American Medical Association, American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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