What is portal vein thrombosis?

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Portal vein thrombosis is the embolism of one or more branches of the portal vein due to thrombosis. This is a common condition in patients with cirrhosis of the liver, liver tumors and depending on the progression to divide acute or chronic portal vein thrombosis.

1. Causes of portal vein thrombosis

Portal vein thrombosis is the result of many different diseases in each specific subject, the most common are liver tumors, hepatocellular carcinoma. In addition, portal vein thrombosis can also be seen in patients with pancreatitis, a genetic disorder of bone marrow proliferation, kidney cancer, pancreatic tumor, cholecystitis, coagulopathy, and inflammation. bowel necrosis. Certain injuries can also be the cause of portal vein thrombosis.
In age groups, the causes of portal vein thrombosis are not the same. In neonates, an infection of the umbilical cord that spreads through the vein to the portal vein can also cause thrombosis there. Portal vein inflammation in older children is also a cause of portal vein thrombosis.
Thus, based on the cause of portal vein thrombosis, experts recommend some of the following subjects who will have a high risk of this condition such as:
People with related diseases such as cirrhosis of the liver, pancreatitis , pancreatic tumor, liver cancer.... People with venous occlusion People with hepatitis B, C People with a family history of portal vein thrombosis People who use a lot of alcohol regularly People who use drugs not according to their needs. prescribed by the doctor, causing burden and toxicity to the liver.

2. Symptoms and diagnosis of portal vein thrombosis

Stage of acute portal vein thrombosis, patients often have unclear manifestations such as: Abdominal pain, nausea, vomiting, anorexia, bloating, diarrhea, unexplained weight loss, Symptoms of cirrhosis, atypical hepatitis.
When it comes to the acute stage, the patient may face bleeding due to rupture of esophageal varices, manifestations of increased venous pressure such as ascites, abnormal splenomegaly, collateral circulation...

In order to accurately diagnose portal vein thrombosis, patients need to be carried out paraclinical methods including:
Liver and kidney function tests Doppler ultrasound to see reduced or lost venous flow, can see the images of thrombosis Some cases are difficult to diagnose, the doctor may prescribe magnetic resonance imaging or contrast CT, angiography ... Manifestations of portal vein thrombosis with increased expression portal pressure without cirrhosis, and other abnormalities in liver function or risk factors such as neonatal umbilical cord infection, pediatric appendicitis, and hypercoagulable disorder. .

3. Treatment of portal vein thrombosis

Take the portal vein thrombosis The condition of portal vein thrombosis, if not treated in time, will lead to vascular occlusion, complications into portal fibrosis. For cases of thrombosis in the acute stage, localized, it is necessary to perform surgery to open the portal vein and remove the thrombus. This method is indicated for acute venous thrombosis, thrombosis localized in the main trunk or the first extrahepatic branch, right and left branches.
However, the method of removing portal vein thrombosis should be contraindicated in cases of chronic portal vein thrombosis, thrombosis that has spread into the veins in the liver, patients with advanced cancer, metastases distant, peritoneal metastases, patients with medical diseases such as cardiovascular, respiratory, coagulation disorders in severe condition.
Portal vein resection, artificial anastomosis This method is indicated for patients with portal vein thrombosis with pancreatic tumor, invasive cholangiocarcinoma of the portal vein. And especially contraindicated for patients with distant metastatic tumors, peritoneal metastases, with serious medical diseases such as respiratory, cardiovascular, blood clotting disorders... The doctor clamps the top and bottom two ends. of the vein, cut the portal vein with invasive tumor and connect the two ends of the vein with an artificial vessel of suitable length and diameter.
Radiation embolization For cancer patients with portal vein thrombosis, the doctor will prescribe radiation embolization. This is a modern new method, creating many positive treatment opportunities for cancer patients. Accordingly, radioactive isotopes are injected directly into the tumor through the artery to focus the radiation dose locally, and at the same time limit the damage to the healthy liver parenchyma. With this method of treatment requires a combination of expertise between 4 specialties: nuclear medicine, interventional cardiology, gastroenterology and diagnostic imaging. Along with the combination of diagnosis and treatment of highly experienced surgical and oncologists.
To perform this method of treatment of portal vein thrombosis for cancer patients, it is necessary to have large costs and modern equipment.

4. Prevention of portal vein thrombosis

For patients with underlying disease that is the main cause of portal vein thrombosis mentioned above, it is necessary to have a healthy diet, combined with creating a habit of regular exercise, between optimism and restraint. use stimulants. And especially periodic health check-ups, monitoring disease progression and treatment according to active prescriptions of doctors.

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