Minireviews
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Hepatol. Feb 27, 2014; 6(2): 64-71
Published online Feb 27, 2014. doi: 10.4254/wjh.v6.i2.64
Portal vein thrombosis in liver cirrhosis
Nao Kinjo, Hirofumi Kawanaka, Tomohiko Akahoshi, Yoshihiro Matsumoto, Masahiro Kamori, Yoshihiro Nagao, Naotaka Hashimoto, Hideo Uehara, Morimasa Tomikawa, Ken Shirabe, Yoshihiko Maehara
Nao Kinjo, Hirofumi Kawanaka, Tomohiko Akahoshi, Yoshihiro Matsumoto, Masahiro Kamori, Yoshihiro Nagao, Naotaka Hashimoto, Hideo Uehara, Morimasa Tomikawa, Ken Shirabe, Yoshihiko Maehara, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Nao Kinjo, Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka 811-1395, Japan
Author contributions: Kinjo N drafted the article; Matsumoto Y, Kamori M, Nagao Y, Hashimoto N and Uehara H contributed to the collection and assembly of manuscripts; Kawanaka H, Akahoshi T, Tomikawa M and Shirabe K participated in the critical revision of the article for important intellectual content; Maehara Y contributed to the final approval of the article.
Correspondence to: Nao Kinjo, MD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. naokinjo@surg2.med.kyushu-u.ac.jp
Telephone: +81-92-6425466 Fax: +81-92-6425482
Received: November 11, 2013
Revised: December 22, 2013
Accepted: January 13, 2014
Published online: February 27, 2014
Processing time: 112 Days and 0.3 Hours
Abstract

Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.

Keywords: Portal vein thrombosis; Liver cirrhosis; Thrombophilic factors; Anticoagulation; Splenectomy

Core tip: Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis; however, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions. The understanding and information on the management of PVT in cirrhosis are incomplete. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.