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World J Hepatol. 2014 Feb 27;6(2):64-71. doi: 10.4254/wjh.v6.i2.64.

Portal vein thrombosis in liver cirrhosis.

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1
Nao Kinjo, Hirofumi Kawanaka, Tomohiko Akahoshi, Yoshihiro Matsumoto, Masahiro Kamori, Yoshihiro Nagao, Naotaka Hashimoto, Hideo Uehara, Morimasa Tomikawa, Ken Shirabe, Yoshihiko Maehara, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.

Abstract

Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.

KEYWORDS:

Anticoagulation; Liver cirrhosis; Portal vein thrombosis; Splenectomy; Thrombophilic factors

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