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Portal vein thrombosis is a rare condition where blood flow from the abdominal organs to the liver is either impeded or completely blocked by a blood clot. It is one of the types of venous thrombosis, which is the existence of an unmoving blood clot in a vein. Portal vein thrombosis affects the hepatic portal vein, which is technically not a vein, but a vessel, because it does not carry blood directly to the heart. It can be found in the abdomen.
Some of the typical causes of portal vein thrombosis include cirrhosis, pancreatitis and diverticulitis. Cancer of the bile ducts, or cholangiocarcinoma, can lead to the condition as well. It can also be a complication of a procedure called a splenectomy in which part or all of the spleen is removed.
In some cases, portal vein thrombosis can be treated with drugs. Blood thinners will sometimes be sufficient to treat the condition. Anticoagulant drugs can also be used to prevent future blood clots from forming, though this sort of treatment is usually only effective for patients who have an acute form of the condition.
It may be necessary to treat portal vein thrombosis with surgery. Bypass surgery, a process in which healthy blood vessels from another part of the body are grafted onto the vessel in order to move blood around the clot, can be used to cure the condition. If the patient does not have adequate vessels for a bypass, a transplant may be necessary. In other cases, the insertion of a small tube known as a shunt can help to free blood flow.
Portal vein thrombosis symptoms depend on the manner and speed with which the blood clot forms in the vessel. There are two primary types of portal vein thrombosis: the more common chronic variety and the rare and difficult to diagnose acute thrombosis. Each type has its own symptoms.
If the condition is chronic, the symptoms are typically easy to detect. They can include bloody vomit, weight loss, and nausea. Some patients also have abdominal pain.
Acute portal vein thrombosis is more difficult to detect via symptoms as they are often mild and not excessively disruptive to the patient. As with the chronic type of the condition, the patient may have nausea or bloody vomit, though it is not as likely. There may be accumulation of fluid in the abdominal area. Some patients also get a fever.