Harmanci Ozgur, Bayraktar Yusuf
Hacettepe University Faculty of Medicine, Department of Gastroenterology, Sihhiye, Ankara, Turkey.
World J Gastroenterol. 2007 May 14;13(18):2535-40. doi: 10.3748/wjg.v13.i18.2535.
The thrombophilia in adult life has major implications in the hepatic vessels. The resulting portal vein thrombosis has various outcomes and complications. Esophageal varices, portal gastropathy, ascites, severe hypersplenism and liver failure needing liver transplantation are known well. The newly formed collateral venous circulation showing itself as pseudocholangicarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of portal vein thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we present and discuss the portal vein thrombosis, etiology and the resulting clinical pictures. There are controversial issues in nomenclature, management (including anticoagulation problems), follow up strategies and liver transplantation. In the light of the current knowledge, we discuss some controversial issues in literature and present our experience and our proposals about this group of patients.
成人期的血栓形成倾向对肝血管有重大影响。由此导致的门静脉血栓形成有多种转归和并发症。食管静脉曲张、门静脉性胃病、腹水、严重脾功能亢进以及需要肝移植的肝衰竭等都是众所周知的。新形成的侧支静脉循环表现为假胆管癌征象,以及其可能作为胆汁淤积的临床反映,也早已为人所知。门静脉血栓形成这些并发症的管理策略与肝硬化门静脉高压的相应策略并无不同,但前一种情况的预后无疑更好。在本综述中,我们介绍并讨论门静脉血栓形成、病因及由此产生的临床表现。在命名、管理(包括抗凝问题)、随访策略和肝移植方面存在一些有争议的问题。根据目前的知识,我们讨论文献中的一些争议问题,并介绍我们对这组患者的经验和建议。