Portal ven trombozu olan hastalarda retrospektif bir çalışma
Year 2025,
Volume: 16 Issue: 2, 365 - 369, 30.06.2025
Mehmet Salim Demir
,
Ahmet Dülger
Abstract
Amaç: Bu çalışmada, portal ven trombozu tanısı almış hastalarda yaş, cinsiyet ve etiyoloji açısından değerlendirme yapılması amaçlanmıştır.
Gereç ve Yöntem: Yüzüncü Yıl Üniversitesi Tıp Fakültesi Dursun Odabaş Eğitim ve Araştırma Hastanesi İç Hastalıkları ve Gastroenteroloji polikliniğine 01.01.2011 ile 31.12.2013 tarihleri arasında başvuran portal ven trombozu (PVT) olan hastaların tıbbi kayıtları retrospektif olarak analiz edilmiştir.
Bulgular: Çeşitli parametreler çerçevesinde yapılan tarama sonucunda, erkeklerde hafif bir baskınlık olduğu gözlemlenmiştir (E/K=39/31). Hastalığın tanı aldığı yaş ortalaması erkeklerde 47, kadınlarda ise 41 olarak bulunmuştur. Yirmi altı hastada birden fazla trombofilik faktör tespit edilmiş, 15 hastada karaciğer sirozu öyküsü mevcutken, 16 hastada ise miyeloproliferatif hastalık saptanmıştır. Bunların yanı sıra, 13 hastada idiopatik PVT tanısı konulmuştur.
Sonuç: Orta ve ileri yaş hastalarda karın ağrısının ayırıcı tanısında PVT mutlaka göz önünde bulundurulmalı, altta yatan karaciğer sirozu veya trombofili gibi hastalıklar mutlaka araştırılmalıdır.
References
-
Sarin SK, Sollano JD, Chawla YK, Amarapurkar D, Hamid S, et al. Consensus on extra-hepatik portal vein obstruction. Liver Int 2006; 26: 512-9.
-
Ogren M, Bergqvist D, Björck M, Acosta S, Eriksson H, et al. Portal vein thrombosis: prevalence, patient characteristics and lifetime risk: apopulation study based on 23,796 consecutive autopsies. World J Gastroenterol 2006; 12: 2115–9.
-
Primignani M, Martinelli I, Bucciarelli P, Battaglioli T, Reati R, et al. Risk factors for thrombophilia in extrahepatic portal vein obstruction. Hepatology 2005; 41: 603–8.
-
Rosendaal FR. Venous thrombosis: a multicausal disease. Lancet 1999; 353: 1167–73.
-
De Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV
consensus workshop on methodology of diagnosis and therapy in portal hypertension.J
Hepatol 2005; 43: 167–76.
-
Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H. Portal vein thrombosis; risk factors,clinical presentation and treatment. BMC Gastroenterol 2007; 7: 34.
-
Kobayashi S, Ng CS, Kazama T, Madoff DC, Faria SC, et al. Hemodynamic and morphological changes after portal vein embolisation: different efforts central and peripheral zones in the liver on multiphasic computed tomography. J Comput Assist Tomog 2004; 28: 804–10.
-
Vilgrain V, Condat B, Bureau C, Hakimé A, Plessier A, et al. Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation. Radiology 2006; 241: 149–55.
-
Bilodeau M, Aubry MC, Houle R, Burnes PN, Ethier C. Evaluationof hepatocytes injury following partial ligation of the left portal vein. J Hepatol 1999; 30: 29–37.
-
Ohnishi K, Okuda K, Ohtsuki T, Nakayama T, Hiyama Y, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients. Gastroenterology 1984; 87: 1150–3.
-
Rajani R, Björnsson E, Bergquist A, Danielsson Å, Gustavsson A, et al. The epidemiology and clinical features of portal vein thrombosis: a multicentre study. Aliment Pharmacol Ther 2010; 32: 1154–1162.
-
Denninger MH, Chait Y, Casadevall N, Hillaire S, Guillin MC, et al. Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 2000; 31: 587-591.
-
Van Gansbeke D, Avni EF, Delcour C, Engelholm L, Struyven J. Sonographic features of portal vein thrombosis. AJR Am J Roentgenol 1985; 144: 749–52.
-
Sun L, Guan YS, Pan WM, Chen GB, Luo ZM, et al. Highly metabolic thrombus of the portal vein: 18F fluorodeoxyglucose positron emission tomography ⁄ computer tomography demonstration and clinical significance in hepatocellular carcinoma. World J Gastroenterol 2008; 14: 1212–7.
-
Webster GJ, Burroughs AK, Riordan SM. Review article: portal vein thrombosis –new
insights into aetiology and management. Aliment Pharmacol Ther 2005; 21: 1–9.
-
Chawla YK, Dilawari JB. Portographic changes with time in patients with extrahepatic portal venous obstruction. J Gastroenterol Hepatol 1988; 3: 421–4.
-
Amitrano L, Guardascione MA, Scaglione M, Pezzullo L, Sangiuliano N, et al. A Prognostic factors in noncirrhotic patients with splanchnic vein thromboses. Am J Gastroenterol 2007; 102: 2464–70.
-
Garcia Pagan JC, Guerra MH, Bosch J. Extrahepatic portal vein thrombosis. Seminars in
Liver diseases 2008; 28: 282–92.
-
Webster GJ, Burroughs AK, Riordan SM.Review article: portal vein thrombosis –new
insights into aetiology and management. Aliment Pharmacol Ther 2005; 21: 1–9.
-
La Mura V, et al. Anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis: a prospective observational study. American Journal of Gastroenterology. 2021;116(7):1447–1464.
-
Khan FY, et al. Risk factors, clinical presentation, diagnosis, and treatment outcomes of portal vein thrombosis: A five-year hospital-based study from Qatar. Journal of Clinical Medicine Research. 2022;14(5):209–217.
-
Dulcetta L, et al. Percutaneous management of chronic total occlusion of the portal vein: a retrospective analysis of technical aspects and outcomes. CVIR Endovascular. 2024;7:81.
-
Willington AJ, Tripathi D. Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis. World Journal of Hepatology. 2024;16(5):751–765.
A retrospective study in patients with portal vein thrombosis
Year 2025,
Volume: 16 Issue: 2, 365 - 369, 30.06.2025
Mehmet Salim Demir
,
Ahmet Dülger
Abstract
Aim: To investigate into the age, gender as well as the etiology of portal vein thrombosis in patients diagnosed with the illness.
Material and methods: The medical records of patients with portal vein thrombus (PVT), who referred to the internal medicine and gastroenterology policlinic at Dursun Odabaş Education and Research Hospital at the Faculty of Medicine in Yuzuncu Yil University between 01.01.2011 and 31.12.2013 were retrospectively analyzed.
Results: As a result of the screening within the context of various parameters, a mild dominance of males was observed (M/F = 39/31), The average diagnosis of the illness in males was found to be 47 within the context of the age; this score was 41 in females. More than one thrombophilic factors were determined in 26 patients and there was a known history of liver cirrhosis in 15 patients, as well as myeloprolifirative disease found in 16 patients. Besides these, 13 of the patients were diagnosed to have idiopathic PVT.
Conclusion: PVT should be taken into consideration in the middle and later age patients in the differential diagnosis of abdominal pain, and any underlying disease like liver cirrhosis or thrombophilia should certainly be investigated.
References
-
Sarin SK, Sollano JD, Chawla YK, Amarapurkar D, Hamid S, et al. Consensus on extra-hepatik portal vein obstruction. Liver Int 2006; 26: 512-9.
-
Ogren M, Bergqvist D, Björck M, Acosta S, Eriksson H, et al. Portal vein thrombosis: prevalence, patient characteristics and lifetime risk: apopulation study based on 23,796 consecutive autopsies. World J Gastroenterol 2006; 12: 2115–9.
-
Primignani M, Martinelli I, Bucciarelli P, Battaglioli T, Reati R, et al. Risk factors for thrombophilia in extrahepatic portal vein obstruction. Hepatology 2005; 41: 603–8.
-
Rosendaal FR. Venous thrombosis: a multicausal disease. Lancet 1999; 353: 1167–73.
-
De Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV
consensus workshop on methodology of diagnosis and therapy in portal hypertension.J
Hepatol 2005; 43: 167–76.
-
Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H. Portal vein thrombosis; risk factors,clinical presentation and treatment. BMC Gastroenterol 2007; 7: 34.
-
Kobayashi S, Ng CS, Kazama T, Madoff DC, Faria SC, et al. Hemodynamic and morphological changes after portal vein embolisation: different efforts central and peripheral zones in the liver on multiphasic computed tomography. J Comput Assist Tomog 2004; 28: 804–10.
-
Vilgrain V, Condat B, Bureau C, Hakimé A, Plessier A, et al. Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation. Radiology 2006; 241: 149–55.
-
Bilodeau M, Aubry MC, Houle R, Burnes PN, Ethier C. Evaluationof hepatocytes injury following partial ligation of the left portal vein. J Hepatol 1999; 30: 29–37.
-
Ohnishi K, Okuda K, Ohtsuki T, Nakayama T, Hiyama Y, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients. Gastroenterology 1984; 87: 1150–3.
-
Rajani R, Björnsson E, Bergquist A, Danielsson Å, Gustavsson A, et al. The epidemiology and clinical features of portal vein thrombosis: a multicentre study. Aliment Pharmacol Ther 2010; 32: 1154–1162.
-
Denninger MH, Chait Y, Casadevall N, Hillaire S, Guillin MC, et al. Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 2000; 31: 587-591.
-
Van Gansbeke D, Avni EF, Delcour C, Engelholm L, Struyven J. Sonographic features of portal vein thrombosis. AJR Am J Roentgenol 1985; 144: 749–52.
-
Sun L, Guan YS, Pan WM, Chen GB, Luo ZM, et al. Highly metabolic thrombus of the portal vein: 18F fluorodeoxyglucose positron emission tomography ⁄ computer tomography demonstration and clinical significance in hepatocellular carcinoma. World J Gastroenterol 2008; 14: 1212–7.
-
Webster GJ, Burroughs AK, Riordan SM. Review article: portal vein thrombosis –new
insights into aetiology and management. Aliment Pharmacol Ther 2005; 21: 1–9.
-
Chawla YK, Dilawari JB. Portographic changes with time in patients with extrahepatic portal venous obstruction. J Gastroenterol Hepatol 1988; 3: 421–4.
-
Amitrano L, Guardascione MA, Scaglione M, Pezzullo L, Sangiuliano N, et al. A Prognostic factors in noncirrhotic patients with splanchnic vein thromboses. Am J Gastroenterol 2007; 102: 2464–70.
-
Garcia Pagan JC, Guerra MH, Bosch J. Extrahepatic portal vein thrombosis. Seminars in
Liver diseases 2008; 28: 282–92.
-
Webster GJ, Burroughs AK, Riordan SM.Review article: portal vein thrombosis –new
insights into aetiology and management. Aliment Pharmacol Ther 2005; 21: 1–9.
-
La Mura V, et al. Anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis: a prospective observational study. American Journal of Gastroenterology. 2021;116(7):1447–1464.
-
Khan FY, et al. Risk factors, clinical presentation, diagnosis, and treatment outcomes of portal vein thrombosis: A five-year hospital-based study from Qatar. Journal of Clinical Medicine Research. 2022;14(5):209–217.
-
Dulcetta L, et al. Percutaneous management of chronic total occlusion of the portal vein: a retrospective analysis of technical aspects and outcomes. CVIR Endovascular. 2024;7:81.
-
Willington AJ, Tripathi D. Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis. World Journal of Hepatology. 2024;16(5):751–765.