The portal vein carries approximately 1 500ml/min of blood from the small and large bowel, spleen and stomach to the liver. Any obstruction or increased resistance to flow, or, rarely, pathological increases in portal blood flow, may lead to portal hypertension. The causes of portal hypertension are categorised as prehepatic, intrahepatic and posthepatic. Although the differential diagnosis is ...

Portal vein thrombosis (PVT) is the presence of thrombus in the portal vein that causes partial or complete occlusion. It is prevalent in hepatocellular carcinoma (HCC), where it can be either bland or malignant depending on the presence of invasion. Recent studies have identified contrast-enhanced ultrasound (CEUS) as the most reliable method of imaging to make this distinction. The arterial n...

In acute portal vein thrombosis (APVT) unrelated to cirrhosis, anticoagulant therapy is classically started with low molecular weight heparin or vitamin K antagonists. New direct-acting oral anticoagulants (DOACs) are used in the treatment of venous thrombosis outside the splanchnic vascular bed, but not in the latter. We report a young female with APVT occurring in a non-cirrhotic liver linked...

Splenoportal axis thrombosis not associated with cirrhosis or neoplasms has a prevalence lower than 5 per 10,000 people. An etiologic factor responsible for portal thrombosis is finally identified in most cases, usually systemic thrombogenic factors or predisposing local factors. However, despite a detailed study of all etiologic factors, up to 30% of cases are eventually considered as idiopath...

Objective: This study investigated the relationship between the incidence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) for chronic portal vein thrombosis (PVT) and the surgical procedures based on the anatomical classification of thrombosis. Methods: In the present retrospective study, 73 consecutive patients were diagnosed with chronic PVT and treat...

Patients with hepatocellular carcinoma may present with variceal bleeding as the initial symptoms. The aims of this study is to investigate the characteristics of such patients. A total of 1046 hepatocellular carcinoma cases were retrospectively retrieved from our computer records between 1980 and 1993. The medical records and image studies were reviewed. The status of each patient was assessed...

BACKGROUND Children with extrahepatic portal hypertension typically present with cavernomatous transformation of the portal vein and a poorly defined intrahepatic portal vein system on conventional imaging. With the Meso-Rex Bypass becoming the gold-standard intervention for a cure, a precise assessment of the intrahepatic portal vein system provides helpful data for deciding whether a Meso-Rex...

The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS), extrahepatic portal vein obstruction (EHPVO), and mesenteric vein thrombosis.Risk factors can be local or systemic. A local precipitating factor is rare in BCS, while it is common in patients with portal vein thrombosis. Chronic myeloproliferative neoplasms (MPN) are the leading systemic cause of splanchnic vein thrombo...

We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensi...

A case of appendicitis which resulted in portal pyaemia, hepatic and splenic abscesses, presumed portal vein thrombosis and subsequent portal hypertension is described. It confirms the merit of ultrasonic imaging in monitoring abscess resolution but questions the ability of the technique to recognise acute suppurative portal endophlebitis.