Portal Vein Thrombosis
The portal vein is a large vein in the abdomen responsible for transporting blood from the intestines and other abdominal organs to the liver. Portal vein thrombosis refers to the blockage or narrowing of the portal vein by a blood clot causing a back up of blood and increased pressure in the portal vein, known as portal hypertension.
Symptoms may include abdominal pain, symptoms of indigestion, fever, leukocytosis, ascites, splenomegaly, hypovolemia, and shock (if associated with bowel infarction). However, most patients are asymptomatic, leading to portal hypertension before the condition is diagnosed.
“About 25% of adults with cirrhosis have portal vein thrombosis, usually because blood flow through the severely scarred liver is slow” (Merck Manual). Other causes include inflammatory abdominal processes (appendicitis, peritonitis, pancreatitis, diverticulitis) trauma, surgical complications, abdominal neoplasms, pregnancy or any condition that makes blood more likely to clot can cause portal vein thrombosis. It can also be idiopathic, or several conditions can cause the blockage.…show more content… Signs include visualization of the blood clot within the lumen of the vessel, however, when the condition is acute it may be difficult to see, as the clot may be hypoechoic, as the condition progresses, it becomes more echogenic and easier to see. It is important to use color doppler to demonstrate presence of flow in the portal vein and even detect partial thrombosis. In chronic cases, the body attempts to bypass this blocked vein by developing collateral veins in the area of the portal vein, this is known as cavernous transformation of the portal