II. Causes

  1. Cirrhosis
  2. Pancreatitis
  3. Hepatocellular Carcinoma
  4. Abdominal Surgery (esp. Gastric Sleeve, the most common surgical cause)
    1. Presents 7-10 days post-op with diffuse Abdominal Pain, Nausea, Vomiting, Leukocytosis
      1. Emergent consult to Bariatric Surgery and Intervention Radiology

III. Symptoms

  1. Acute
    1. Sudden onset Right Upper Quadrant or Epigastric Abdominal Pain
    2. Vomiting
  2. Chronic
    1. Intermittent mild Abdominal Pain

V. Differential Diagnosis

  1. Budd-Chiari Syndrome (Hepatic Vein Thrombosis)
  2. Cirrhosis
  3. Sarcoidosis

VI. Labs

VII. Diagnosis

  1. CT Abdomen Pelvis with IV Contrast
  2. Doppler Ultrasound
  3. MRI with MRA
  4. Angiography

VIII. Management

  1. See Portal Hypertension
  2. See Esophageal Varices
  3. Initially treated with Heparin (and in some cases catheter directed or systemic Thrombolytics)
    1. Anticoagulation
    2. Directed Thrombolysis
  4. Surgical hepatic shunt placement

IX. Complications

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Ontology: Portal vein thrombosis (C0155773)

Definition (NCI) The formation of a blood clot (thrombus) in the portal vein.
Definition (NCI_CTCAE) A disorder characterized by the formation of a thrombus (blood clot) in the portal vein.
Concepts Disease or Syndrome (T047)
ICD9 452
ICD10 I81
SnomedCT 155455003, 17920008
English Deep vein thrombos portal vein, thrombosis of portal vein, thrombosis of portal vein (diagnosis), Thrombosis portal vein, Pylethrombosis, Portal Vein Thrombosis, pylethrombosis, portal thrombosis, thrombosis portal vein, Thrombosis;portal, portal vein thrombosis, portal thrombosis vein, Portal vein thrombosis, Deep vein thrombosis of portal vein, PVT - Portal vein thrombosis, Portal vein thrombosis (disorder), portal; thrombosis, thrombosis; portal
Italian Trombosi della vena porta, Piletrombosi
Dutch pyletrombose, vena portalis trombose, porta; trombose, trombose; porta, Trombose van vena portae, vena portae trombose
French Pyléthrombose, Thrombose de la veine porte, Thrombose porte
German Thrombose der Pfortader, Pfortaderthrombose
Portuguese Piletrombose, Trombose da veia porta
Spanish Piletrombosis, trombosis de la vena porta (trastorno), trombosis de la vena porta, Trombosis de la vena porta
Japanese 門脈血栓症, モンミャクケッセンショウ
Czech Trombóza venae portae, Trombóza portální žíly, Pyletrombóza
Korean 문맥혈전증
Hungarian vena portalis thrombosis, Pylethrombosis, Portalis vena thrombosis