Overview
When was portal vein obstruction first reported?
What is the pathophysiology of portal vein obstruction?
What causes portal vein obstruction?
What is stasis in portal vein obstruction?
How does portal vein obstruction affect liver function and what are the complications?
What causes portal vein obstruction in children?
What causes portal vein obstruction in adults?
What is the incidence of portal vein obstruction in the US?
What is the international incidence of portal vein obstruction?
What are the demographics of portal vein obstruction?
What are the complications of portal vein obstruction?
What is the prognosis of portal vein obstruction?
What are the mortality and morbidity of portal vein obstruction?
Presentation
How is the presentation of portal vein obstruction characterized?
What is the patient’s clinical history in chronic portal vein obstruction?
What are the physical findings in portal vein obstruction?
DDX
What are the diagnostic considerations in portal vein obstruction?
What are the differential diagnoses for Portal Vein Obstruction?
Workup
Which lab studies are indicated in the workup of portal vein obstruction?
What is the role of ultrasonography in the workup of portal vein obstruction?
What is the role of endoscopic ultrasonography (EUS) in the workup of portal vein obstruction?
What is the role of MRI/MRA in the workup of portal vein obstruction?
What is the role of CT scanning in the workup of portal vein obstruction?
What is the role of angiography in the workup of portal vein obstruction?
What are the histologic findings in portal vein obstruction?
Treatment
How is acute bleeding controlled in patients with portal vein obstruction?
What is the role of anticoagulation in portal vein obstruction?
What is the role of thrombolysis in the treatment of portal vein obstruction?
When is transfer indicated in the treatment of portal vein obstruction?
What follow-up care is indicated for patients with portal vein obstruction?
What is the role of shunt surgery in the treatment of portal vein obstruction?
Which specialist consultations are indicated in the management of portal vein obstruction?
Medications
What are the goals of drug treatment for portal vein obstruction?
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The etiology of portal vein obstruction.
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Coagulation disorders in portal vein thrombosis.
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Portal vein thrombosis with cavernous transformation. The long arrow indicates the splenic vein at the junction with the superior mesenteric vein just below the site of the thrombosis. The short arrow points to a serpiginous mass consistent with periportal collaterals, the so-called cavernous transformation of the portal vein.
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Hepatocellular carcinoma with portal vein thrombosis. The short arrow indicates the tumor thrombus with an abrupt cut off of the portal vein. The long arrow points to a compensatory, prominent left hepatic arterial branch.