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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]
Inferior mesenteric vein; The superior mesenteric vein and the splenic vein come together to form the actual hepatic portal vein. 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 ...
In embolic acute intestinal ischemia, CT-Angiography can be of great value for diagnosis and treatment. It may reveal the emboli itself lodged in the superior mesenteric artery, as well as the presence or absence of distal mesenteric branches. [18] Late findings, which indicate dead bowel, include: Intramural bowel gas [29] Portal venous gas
A portacaval anastomosis or portocaval anastomosis is a specific type of circulatory anastomosis that occurs between the veins of the portal circulation and the vena cava, thus forming one of the principal types of portasystemic anastomosis or portosystemic anastomosis, as it connects the portal circulation to the systemic circulation, providing an alternative pathway for the blood.
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 portal vein is usually formed by the confluence of the superior mesenteric , splenic veins , inferior mesenteric , left , right gastric veins and the pancreatic vein .
As the superior mesenteric vein drains to the hepatic portal vein, the middle colic vein is considered part of the hepatic portal system. This vein also carries nutrients absorbed from the large intestine to the liver. This vein is sometimes used as the point of catheter insertion for treatment of acute portal and mesenteric vein thrombosis. [2]
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
Treatment generally includes supportive care including pain management and possibly diuretics. [5] In those with severe disease due to a bone marrow transplant, defibrotide is a proposed treatment. [6] It has been approved for use in severe cases in Europe and the United States. [7] [8] A placebo controlled trial, however, has not been done as ...