Jo Hoon Gil, Kim Youe Ree, Cho Eun Young
Department of Radiology, Wonkwang University School of Medicine, Iksan, Korea.
Korean J Gastroenterol. 2021 Sep 25;78(3):177-182. doi: 10.4166/kjg.2021.050.
The treatment of portal vein thrombosis (PVT) in patients with liver cirrhosis (LC) has been controversial, and it is generally case- and institution-dependent. The occurrence of acute or extensive PVT is critical and requires urgent treatment because it is usually accompanied by symptoms, particularly when total occlusion occurs, causing acute decompensation of liver disease. Even in severe cases, drug selection and treatment duration are determined based on each institution's experience. Therefore, consistent guidelines for the treatment of patients with LC with PVT are required. Recently, a patient with acute occlusive PVT with LC who showed signs of acute decompensation was treated by administering low molecular weight heparin as anticoagulant therapy. After anticoagulant treatment, the portal vein was almost completely recanalized, and the deteriorated liver function improved. In addition, the patient recovered well and showed no recurrence of PVT for more than a year. Thus, the most recent knowledge regarding the treatment of nonmalignant PVT in LC was reviewed along with a case report.
肝硬化（LC）患者门静脉血栓形成（PVT）的治疗一直存在争议，通常取决于具体病例和医疗机构。急性或广泛性PVT的发生至关重要，需要紧急治疗，因为它通常伴有症状，尤其是在完全闭塞时，会导致肝病急性失代偿。即使在严重病例中，药物选择和治疗持续时间也基于各医疗机构的经验来确定。因此，需要针对LC合并PVT患者治疗的统一指南。最近，一名患有急性闭塞性PVT且出现急性失代偿迹象的LC患者接受了低分子量肝素抗凝治疗。抗凝治疗后，门静脉几乎完全再通，肝功能恶化情况得到改善。此外，患者恢复良好，PVT在一年多时间里未复发。因此，结合一例病例报告对LC中非恶性PVT治疗的最新知识进行了综述。
