Savoia Fabiana, Ferrara Cinzia, Sansone Anna, Bifulco Giuseppe, Nappi Carmine, Di Carlo Costantino
Dipartimento di Neuroscienze e Scienze della Riproduzione, Università degli Studi di Napoli Federico II, Via Pansini No. 5, 80131 Napoli, Italy.
Case Rep Obstet Gynecol. 2013;2013:396083. doi: 10.1155/2013/396083. Epub 2013 Dec 10.
Portal vein thrombosis (PVT) is characterized by the obstruction of the portal venous system. The venous obstruction can be partial or complete and it is caused by thrombogenic conditions (acquired or hereditary) or nonthrombotic factors. The acquired conditions include abdominal inflammation, infections, surgery, myeloproliferative disorders, obesity, oral contraceptive intake, pregnancy, and postpartum period. Occasionally, it is not possible to recognize any overt cause of PVT. During pregnancy there is an increased venous thromboembolism risk mainly in the systemic venous system and the PVT can occur, but there are no data about its exact prevalence, etiology, and outcome. The portal cavernoma is the cavernomatous transformation of the portal vein. It is a consequence of chronic PVT and occurs when myriads of collateral channels develop to bypass the occlusion. The clinical presentation includes hematemesis due to variceal bleeding, ascites or anaemia, and splenomegaly. The cavernous transformation of the portal vein is easily diagnosed by sonography. We report our case of a 32-year-old, gravida 3 para 2, pregnant woman admitted to our hospital at 13 weeks and 1 day of gestation, clinically asymptomatic. Laboratory test, ultrasound, and endoscopic evaluation were negative. After a detailed counseling, the patient decided on termination of pregnancy at 15 weeks and 1 day of gestation.
门静脉血栓形成(PVT)的特征是门静脉系统阻塞。静脉阻塞可为部分性或完全性,由血栓形成性疾病(获得性或遗传性)或非血栓形成因素引起。获得性疾病包括腹部炎症、感染、手术、骨髓增殖性疾病、肥胖、口服避孕药、妊娠及产后期。偶尔,无法识别PVT的任何明显病因。妊娠期间,主要在体静脉系统静脉血栓栓塞风险增加,PVT可能发生,但关于其确切患病率、病因及转归尚无数据。门静脉海绵样变性是门静脉的海绵样改变。它是慢性PVT的结果,当无数侧支循环形成以绕过阻塞时发生。临床表现包括因静脉曲张出血导致的呕血、腹水或贫血以及脾肿大。门静脉海绵样变性通过超声检查很容易诊断。我们报告一例32岁、孕3产2的孕妇,妊娠13周零1天时入住我院,临床无症状。实验室检查、超声及内镜评估均为阴性。经过详细咨询,患者决定在妊娠15周零1天时终止妊娠。