Usually portal vein clots causes portal hypertension and GI bleeding from tortuous vessels usually in the lower esophagus or stomach. Diagnosis is based on ultrasonography. "Treatment involves control of variceal bleeding (usually with endoscopic banding, IV octreotide, or both), prevention of recurrence using β–blockers and sometimes surgical shunts and thrombolysis (blood clots) for acute thrombosis.
A Case Report"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279509/
Take care.
Your spleen would likely be enlarged with a below normal platelet count. Your imaging would also show an increased portal vein diameter. And the portal blood flow into the liver would be affected, and may even be reversed. So your doctors will likely be able to pickup on whether you're dealing with portal hypertension.
So maybe you do not have portal hypertension, just splenomegaly and a relatively wide portal vein. If you eat or drink coffee before the ultrasound, the portal vein also expands.
But the definite answer lies in the gastroscopy or wedged pressure measurement, as i mentioned before, so try to get that. If you complain about intense reflux disease, you can easier get a gastroscopy, since one tries to exclude Barretts esophagus.
Then in 10/2018 her Salem, Oregon doctors informed her she had a blood clot in her portal vein. Her doctors put her on Eliquis to treat the blood clot. Then in 6/2019 she was informed that the blood clot was gone. She stopped her Eliquis as directed. Then in 10/2019, she was informed again that she had a blood clot in her portal vein. A referral was done at the beginning of 2020 (at our own request) to University of Washington Medical Center Transplant Team.
But, the flow at any instance, during a given heart beat, will be a time-varying ratio of some artery flux, and some portal flux. The net, integrated result of flow, per unit time, is a very complicated waveform function of peaks and valleys - some flow outwards from the liver (hepatofugal) and some flow inwards toward the liver (hepatopetal). And of course, any internal resistance to this flow will alter the final shape of the net flow curve.
Portal vein obstruction results from thrombosis (blood clot) or narrowing of the portal vein, which brings blood to the liver from the intestines. Portal vein thrombosis that develops in people with cirrhosis will cause their condition to deteriorate. Most people have no symptoms. Fluid may accumulate in the abdomen, the spleen may enlarge, and severe bleeding may occur in the esophagus.
Under X-RAY guidance, doctors are then able to establish within the substance of the liver an artificial tract or shunt to directly drain the portal vein into the general circulation. This is done via the use of several inflatable balloons followed by the careful insertion of an expandable, wire mesh stent.
The normal diameter of the portal vein is 12mm, so there is marginal dilatation. If the liver function tests are normal, you can go for a follow up at intervals to see if it is progressing. Besides liver disorders dilatation can occur if there is any distal obstruction to the venous flow.
Hope this helped and do keep us posted.
i had my bypass surgery done in1995 becuse of 3VD at that time. I was advised a Coronary Angiogram, after I complained about my chest pain after breakfast. Angiogram report came thus:
LMCA :Normal
LAD: total (100%) occlusion at mid segment ; LIMA to LAD patent
LCX: total occlusion at mid segment ; SVG to OM - total occlusion at origin.
RCA: Dominant ; total occlusion mid segment ;retrograde filling via bridging collaterals ; SVG to RCA - totally occluded at orogin
Impression: Severe 3VD.
I recently had a routine MRI to monitor my cirrhosis and portal vein thrombosis, and a small 2cm tumor was found. My hepatologist consulted with the interventional radiologist, and they agreed that ablation of the tumor is the best course of treatment (I am on the transplant list at a N.Y. hospital).
Have others here had this procedure? Can you share your experiences? Is it possible that this will permanently remove the tumor? I’m a bit overwhelmed right now!
Thank you.
We can have portal hypertension without having cirrhosis due to the portal vein being compressed in our fibrotic portal tracts. Is your spleen enlarged?
I have had many liver biopsies, and it provided great insight as to what is going on. My doctors tell me that I am end-stage, but my bilirubin is normal, ALP is always elevated of course.
Yes, color Doppler ultrasound can detect reversal of flow in the portal vein. With portal hypertension, blood is unable to get through the liver and get back to the heart. The portal vein dilates, flow reversal occurs as blood finds another route. Recanalization of the ligamentum venosum can occur leading to varices near the umbilicus and esophageal varices can develop which can lead to vomiting blood.
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Color Doppler sonography may show portal vein flow reversal or portal collaterals, prompting the diagnosis of portal hypertension. Flow reversal or portal collaterals may be the only finding indicating severe liver disease in a patient with otherwise normal findings. Conspicuously enlarged and tortuous hepatic arteries are sometimes shown on CDS in cirrhotic livers (Fig. 9⇓).
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