von Köckritz Leona, De Gottardi Andrea, Trebicka Jonel, Praktiknjo Michael
Hepatology, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland.
Department of Clinical Research, University of Bern, Bern, Switzerland.
Gastroenterol Rep (Oxf). 2017 May;5(2):148-156. doi: 10.1093/gastro/gox014. Epub 2017 Apr 24.
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.
门静脉血栓形成(PVT)在肝硬化患者中很常见,而诸如肠系膜缺血等可能的严重并发症很少见,但可能危及生命。然而,PVT在临床相关性、诊断和管理等不同方面在国际指南中仍是不确定和有待研究的领域。在本文中,我们阐述了PVT的分类、临床表现的地域差异和诊断标准,并简要介绍了目前对病理生理学的认识和危险因素。本综述探讨并强调了各种治疗方法和预防性治疗的陷阱。最后,我们回顾了PVT对预后的临床影响这一有争议的问题,特别是考虑到肝移植和未来展望。