Portal vein thrombosis in patients with cirrhosis

Gastroenterol Rep (Oxf). 2017 May;5(2):148-156. doi: 10.1093/gastro/gox014. Epub 2017 Apr 24.

Abstract

Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors. This review considers and highlights the pitfalls of the various treatment approaches and prophylactic treatments. Finally, we review the controversial issue of clinical impact of PVT on prognosis, especially considering liver transplantation and future perspectives.

Keywords: liver cirrhosis; liver transplantation; low-molecular-weight heparin; portal vein thrombosis; thrombophilia tests; transjugular intrahepatic portosystemic shunt.