A REVIEW ON DIAGNOSIS AND TREATMENT OF PORTAL VEIN

THROMBOSIS

Banoth Subhadra *, Syeda Nishat Fathima

Department of Pharmacology
Jayamukhi College of Pharmacy, Narsampet, Warangal

Portal vein thrombosis (PVT), previously known as Cauchois–Eppinger–Frugoni syndrome is a

form of venous thrombosis affecting the hepatic portal vein, which can lead to portal hypertension and
reduction in the blood supply to the liver. In the acute phase, the presentation of portal vein obstruction is
relatively uncommon and easily missed because the patient may be asymptomatic. Symptoms most often
begin in the chronic or subacute stage. Right upper quadrant pain, nausea, and/or fever along with
Splenomegaly, Ascites, Increased risk of spontaneous bacterial peritonitis and hepatorenal syndrome
may be the clinical features of PVT. Causes of PVT include pancreatitis, cirrhosis, diverticulitis, and
cholangiocarcinoma. The diagnosis of portal vein thrombosis is usually made by ultrasound, computed
tomography with contrast or magnetic resonance imaging. D-dimer levels in the blood may be elevated as
a result of fibrin degradation. Acutely only the thrombus may be evident, with associated findings related
to ischemic bowel. In chronic cases, cavernous transformation of the portal vein may be seen, with
numerous periportal veins replacing the normal single channel of the portal vein.

In symptomatic noncarvenomatous PVT, anticoagulation is recommended with low molecular

weight heparin. Oral anticoagulants, Beta-adrenergic blocking agents, Somatostatin analogs and
thrombolytic agents are used as pharmacotherapic agents to reduce morbidity and to prevent
complications.In patients with cavernomatous formation of portal vein or chronic PVT, decompressive
shunt surgery, should be performed if endotherapy fails to prevent bleeding from varices especially in
children. Rarely liver transplantation may be considered. There was a 93% survival with bleeding
control, and 82% had a patent conduit.

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