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Portal vein thrombosis, incidental PM finding. Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, which can lead to increased pressure in the portal vein system and reduced blood supply to the liver. The mortality rate is approximately 1 in 10. [1]
A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [18] On Doppler ultrasonography, a slow velocity of <16 cm/s in addition to dilatation in the main portal vein are diagnostic of portal hypertension. [19]
Doppler ultrasound of the liver is typically utilized to confirm or suggest the diagnosis. Common findings on liver doppler ultrasound include increased phasicity of portal veins with eventual development of portal flow reversal. The liver is usually enlarged but maintained normal echogenicity. A liver biopsy is required for a definitive diagnosis.
Also, unlike ultrasonography of deep venous thrombosis, the procedure focuses mainly on superficial veins. Also, unlike the arterial ultrasound examination, blood velocity in veins has no diagnostic meaning. Veins are a draining system similar to a low pressure hydraulic system, with a laminar flow and a low velocity.
The location of the thrombus and its detail will inform of the seriousness of the condition. In a deep vein thrombosis (DVT), or in a superficial vein thrombosis where the thrombus is floating, an emergency situation will be indicated. If the thrombus is near to the sapheno-femoral junction there will be a high risk of a pulmonary embolism ...
For example, in portal hypertension, there is an abnormal portal venous flow where it flows away from the liver (hepatofugal flow) instead of the normal flow towards liver (hepatopetal flow). In jugular venous pressure waveform of the internal jugular vein, the retrograde "a" waveform is a normal flow due to right atrium contraction. Both ...
Portal venous pressure is the blood pressure in the hepatic portal vein, and is normally between 5-10 mmHg. [1] Raised portal venous pressure is termed portal hypertension , [ 2 ] and has numerous sequelae such as ascites and hepatic encephalopathy .
A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [8] On Doppler ultrasonography , the main portal vein (MPV) peak systolic velocity normally ranges between 20 cm/s and 40 cm/s. [ 9 ]