Extrahepatic Portal Vein Thrombosis

  • – Common cause of portal HTN in children
  • – Prehepatic, presinusoidal thrombosis

 

Common causes of Portal Vein thrombosis

  • – Hematologic disorders: PRV, Myeloproliferative neoplasia
  • – Prothrombotic conditions: anti-thrombin, protein C, S deficiency
  • – – Antiphospholipid antibody syndrome
  • – PNH
  • – Oral contraceptive use
  • – Intraabdominal malignancy
  • – Inflammatory disease: Pancreatitis, IBD, diverticulitis
  • – Umbilical vein sepsis
  •               • 25% cirrhotic patients develop portal vein thrombosis

                     Treatment of extrahepatic portal vein thrombosis

Aim:

  • Control variceal bleeding
  • Prevent recurrent variceal bleeding

Treatments:

Anticoagulation

  • – If varices are not large
  • – Thrombocytosis present

Thrombolytic therapy

  • – If acute portal vein thrombosis extends to superior mesenteric artery to prevent intestinal ischemia

Endoscopic therapy

  • – To control acute variceal bleeding and to prevent recurrent bleeding

– Beta blocker therapy

– Surgical porto-systemic shunt

  • • If conservative therapy does not control bleeding

Copyrights © 2021 Arefin | Gastroenterology | Developed by Chumbok IT