Portal vein thrombosis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
===Acute=== | ===Acute=== | ||
* | *Upper abdominal pain developing suddenly or progressing over a few days | ||
*May be clinically silent in a portion of patients and diagnosed during a CT exam for other reasons (e.g. acute [[pancreatitis]]) | *Possibly accompanied by nausea, hepatomegaly, splenomegaly; may be accompanied by persistent non-spiking fever in the setting of systemic inflammation | ||
*Other signs/symptoms based on underlying cause (e.g. bleeding disorders, hepatic stigmata if due to cirrhosis) | |||
===Chronic=== | |||
*May be clinically silent in a portion of patients and diagnosed incidentally during a CT exam for other reasons (e.g. acute [[pancreatitis]]) | |||
*Associated with portal hypertension | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 01:08, 24 April 2020
Background
Inciting Causes
- Abdominal sepsis
- Abdominal surgery
- Behçet's syndrome
- Cirrhosis
- Collagen vascular diseases (eg, lupus)
- Compression or invasion of the portal vein by tumor (eg, pancreatic cancer)
- Endoscopic sclerotherapy
- Hepatocellular carcinoma
- Inflammatory bowel disease
- Inherited thrombophilias
- Myeloproliferative syndromes
- Omphalitis
- Oral contraceptives
- Pancreatic islet cell transplantation
- Pancreatitis
- Paroxysmal nocturnal hemoglobinuria
- Pregnancy
- Retroperitoneal fibrosis
- Transjugular intrahepatic portosystemic shunt
- Trauma
Clinical Features
Acute
- Upper abdominal pain developing suddenly or progressing over a few days
- Possibly accompanied by nausea, hepatomegaly, splenomegaly; may be accompanied by persistent non-spiking fever in the setting of systemic inflammation
- Other signs/symptoms based on underlying cause (e.g. bleeding disorders, hepatic stigmata if due to cirrhosis)
Chronic
- May be clinically silent in a portion of patients and diagnosed incidentally during a CT exam for other reasons (e.g. acute pancreatitis)
- Associated with portal hypertension
Differential Diagnosis
Evaluation
- Typically diagnosed on abdominal CT with contrast