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Portal Vein Thrombosis
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Portal Vein Thrombosis
Causes
Cirrhosis
Pancreatitis
Hepatocellular Carcinoma
Abdominal Surgery (esp.
Gastric Sleeve
, the most common surgical cause)
Presents 7-10 days post-op with diffuse
Abdominal Pain
,
Nausea
,
Vomiting
,
Leukocytosis
Emergent consult to
Bariatric Surgery
and
Intervention Radiology
Symptoms
Acute
Sudden onset Right Upper Quadrant or
Epigastric Abdominal Pain
Vomiting
Chronic
Intermittent mild
Abdominal Pain
Signs
Hepatomegaly
Splenomegaly
Ascites
Ankle
edema
Differential Diagnosis
Budd-Chiari Syndrome (Hepatic Vein Thrombosis)
Cirrhosis
Sarcoidosis
Labs
Liver Function Test
s
Hypercoagulable
evaluation
Diagnosis
CT Abdomen
Pelvis
with IV Contrast
Doppler Ultrasound
MRI with MRA
Angiography
Management
See
Portal Hypertension
See
Esophageal Varices
Initially treated with
Heparin
(and in some cases catheter directed or systemic
Thrombolytic
s)
Anticoagulation
Directed
Thrombolysis
Surgical hepatic shunt placement
Complications
Portal Hypertension
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