Handa Pankaj, Crowther Mark, Douketis James D
Department of Medicine, McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
Department of Medicine, McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada.
Clin Appl Thromb Hemost. 2014 Jul;20(5):498-506. doi: 10.1177/1076029612473515. Epub 2013 Jan 29.
With advances in modern imaging techniques, portal vein thrombosis (PVT) is being increasingly diagnosed. It has a wide ranging clinical spectrum from being an asymptomatic state to a potentially life-threatening situation. It is not unusual to find it as an incidental finding in the abdominal imagings done for other reasons. It is commonly associated with cirrhosis and abdominal malignancies and also has a strong association with prothrombotic disorders. It is often difficult for the clinicians to decide whether PVT is acute or chronic. This poses great challenges to its management strategies that include anticoagulants, thrombolysis, and surgical options. Timely diagnosis and appropriate management have great bearings on its outcomes of morbidity and mortality. In this clinician-oriented review, we have provided a concise review of clinical aspects of PVT and discussed various management strategies while addressing the common questions that come to a physician's mind dealing with such a patient.
随着现代成像技术的进步,门静脉血栓形成(PVT)的诊断越来越多。它的临床谱广泛,从无症状状态到潜在的危及生命的情况。在因其他原因进行的腹部成像中偶然发现它并不罕见。它通常与肝硬化和腹部恶性肿瘤相关,也与血栓形成前疾病有很强的关联。临床医生常常难以确定PVT是急性还是慢性。这对其管理策略(包括抗凝、溶栓和手术选择)构成了巨大挑战。及时诊断和适当管理对其发病率和死亡率的结果有很大影响。在这篇以临床医生为导向的综述中,我们对PVT的临床方面进行了简要综述,并讨论了各种管理策略,同时回答了医生在处理此类患者时常见的问题。