Portal vein carries venous blood from the spleen to the liver for the purpose of detoxification, and then returns it for circulation through the hepatic nerve. The portal vein can get blocked due to the development of a blood clot. The following article provides information about the causes and symptoms of this condition.
The portal vein is a large vein that carries blood from the abdomen and the intestine to the liver. It is located at the confluence of the splenic and the superior mesenteric vein. These veins are situated behind the pancreatic head. In ailments that relate to the hepatic nerve and cause the portal vein thrombosis, the process of thrombosis starts at the intrahapatical portal vein, and gradually extends towards the extrahepatic portal vein. Whereas in certain other cases, the process of thrombosis begins at the origin of the portal vein.
Sometimes, disorders associated with the clotting of blood are acquired or inherited. It results in problems such as an enlarged liver or severe abdominal pain. Acquired disorders have antithrombin III deficiency, that leads to malnutrition, sepsis, disturbed bowel movements, and liver disease that may be fatal. Inherited disorders have distinct variations in the prothrombin gene G20210A, accompanied by deficiencies in activated protein C resistance and protein S.
Another major cause of this condition is stasis, in which the blood flow is obstructed due to cirrhosis. The enlargement of veins that connect the intestine to the esophagus is also a major cause. Sclerotherepy, even though not completely proven is believed to be the most effective mechanism. Tumor compression and infections can also lead to this condition. Infections can be another major cause of this condition.
The obstruction does not adversely affect the functioning of the liver. This condition, in fact affects an individual who is inflicted by a liver disease such as cirrhosis. Collaterals (side branch of a blood vessel) are formed after an acute thrombosis has occurred, though the formation takes around 5 weeks, it is described to have taken shape in 12 days in certain peculiar cases. The formation of collaterals further complicates matters, as it leads to an increased risk of developing variceal hemorrhage.
Symptoms of portal vein thrombosis include:
- Enlarged spleen
- Enlarged abdomen
- Abdominal pain
- Blood in stool
- Portal hypertension
- The treatment for this condition involves the removal of the clots present in acute cases. This treatment is meant especially for those who have inherent coagulation troubles. Thus, by following this treatment, clotting could be prevented. A lifelong anti-coagulation or anti-clotting treatment should be administered in order to prevent any disorder that may lead to the clotting of blood. Anti-coagulation therapy is a must to prevent rethrombosis.
- Thrombolysis is another treatment or rather an approach that is highly recommended in acute cases. The method of trans-hepatic route is adopted in order to discard the need of systemic thrombosis.
- Performing a shunt surgery is also an alternative to anticoagulation therapy that could be adopted to deal with acute hepatic portal vein thrombosis.
- An anticoagulation therapy can be carried out when accompanied with a tissue – type plasminogen activator. This is a line of treatment that could serve to be a good alternative while dealing with hepatic portal vein thrombosis.
- A method referred to as TIPS (transjugular intrahepatic portosystemic shunt) is a successful method in countering this condition. TIPS is suggested when the variceal bleeding becomes uncontrollable in the patient who has contracted liver cirrhosis. A shunt placement followed by angioplasty of the tract is performed. TIPS is said to be comparatively less invasive than a shunt surgery.
Consult a surgeon or an expert in this field before considering any treatment.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.