Liver
VAsCUlAR
(1}
LivER
PORTAl
Dis'EASES
VEiN TItRoMbosis
Causes 1- Blood disease e.g. polycythemia. 2- Pancreatic tumor and hepatoma vein.
may invade and compress
the portal
3- Umbilical sepsis. 4- Postoperative, commonly after splenectomy.
Clinical Picture Portal hypertension with bleeding from oesophageal varices. -
The spleen is usually enlarged.
-
The liver is normal in size and consistency.
-
Ascites is early and transient, (it is usually subsides as the collateral circulation develops). Ascites is usually related to an additional factor which has depressed the liver function e.g haemorrhage.
Investigations •
Duplex scan.
•
Liver histology is normal.
Treatment
(any underlying cause must be identified and treated)
As portal hypertension, but surgery is difficult due to absence of patent veins for portal - systemic shunts.
(2 Hepatic vein occlusion, & sometimes the
tvc.
Causes 1- Oral c.c. pills. 2- Polycythaemia. 3- Hyper coagulable states e.g. Protein C & S deficiency.
Diagnosis 12345-
Abdominal pain. Tender hepatomegally. Ascites + portal hypertension. LL edema with IVC obstruction. Negative hepatojugular reflux.
Investigations •
Duplex scan.
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