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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]
This rare, potentially life-threatening syndrome is typically caused by an angle of 6–25° between the AA and the SMA, in comparison to the normal range of 38–56°, due to a lack of retroperitoneal and visceral fat (mesenteric fat). In addition, the aortomesenteric distance is 2–8 millimeters, as opposed to the typical 10–20. [1]
In human anatomy, the superior mesenteric vein (SMV) is a blood vessel that drains blood from the small intestine (jejunum and ileum). Behind the neck of the pancreas , the superior mesenteric vein combines with the splenic vein to form the portal vein that carries blood to the liver .
The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart. It is a major component of the hepatic portal system , one of three portal venous systems in the human body; the others being the hypophyseal and renal portal systems.
The inferior mesenteric vein connects in the majority of people on the splenic vein, but in some people, it is known to connect on the portal vein or the superior mesenteric vein. Roughly, the portal venous system corresponds to areas supplied by the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery.
This may reveal the size and shape of the abdominal organs, and Doppler studies may show the direction of flow in the portal vein, as well as detecting Budd–Chiari syndrome (thrombosis of the hepatic vein) and portal vein thrombosis. The sonographer also can estimate the amount of ascitic fluid, and difficult-to-drain ascites may be drained ...
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 ]
The human hepatic portal system delivers about three-fourths of the blood going to the liver.The final common pathway for transport of venous blood from spleen, pancreas, gallbladder and the abdominal portion of the gastrointestinal tract [2] (with the exception of the inferior part of the anal canal and sigmoid colon) is through the hepatic portal vein.