What Is an Ambulatory Phlebectomy?

Portal vein thrombosis (PVT) can occur in any segment of the portal vein. The etiology is unknown in more than half of the cases, but may be related to systemic or local infections (such as purulent portal phlebitis, cholecystitis, lymphadenitis in the vicinity, pancreatitis, and liver abscess).

Portal vein thrombosis

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Portal vein thrombosis

PVT can occur in 10% of patients with cirrhosis and is often complicated by hepatocellular carcinoma. PVT can also occur during pregnancy (especially

When portal hypertension is present and liver function is normal, the presence of PVT should be suspected. Ultrasound and CT can help diagnose, but the diagnosis depends on angiography (such as transsplenoportal angiography, venous phase of superior mesenteric arteriography) or MRI.

In patients with acute PVT, anticoagulant treatment is too late because a blood clot has formed, but it prevents the spread of the blood clot. For chronic PVT patients, conservative treatment can be given. For esophageal varices bleeding, endoscopic esophageal venous embolization should be the first choice. Surgical decompression of the portal system has many problems because there are often no suitable veins for proper shunting. If the splenic vein is not blocked, it can be used as a distal splenorenal shunt. If this fails, a mesenteric-caval shunt is feasible. Since small veins are more prone to thrombosis, shunting in children should be delayed as much as possible.