Portal vein thrombosis is a disease that usually does not immediately lead to symptoms and is therefore characterized by a rather gradual course. In the acute state of portal vein thrombosis, immediate action is required.
What is portal vein thrombosis?
The term portal vein thrombosis is a compound word consisting of portal vein and thrombosis. In connection with the localization of the thrombosis, the Venae portae are affected in this clinical picture. The portal vein is a special blood vessel responsible for carrying blood to the liver. See electronicsencyclopedia for Slang Compulsion to Buy.
In medicine, a thrombosis is used when, as in the case of portal vein thrombosis, the portal vein is blocked by a so-called clot, which settles in the vessel and impairs or prevents blood supply or drainage. Portal vein thrombosis is a rare form of thrombosis that is already known from other cardiovascular diseases.
Portal vein thrombosis usually occurs when unfavorable underlying diseases are already present. These are tumor growths in the pancreas or in the tissues of the liver.
Another cause of portal vein thrombosis can be an inflammatory process in the pancreas. Like hepatitis, this is accompanied by swelling of the affected organ and can lead to portal vein thrombosis. People who have an increased tendency to form blood clots, are “dehydrated” from not drinking enough fluids, or have become poisoned can also develop portal vein thrombosis.
This applies equally to patients who take certain medications and live with an increased risk of developing venous thrombosis. Portal vein thrombosis can also be promoted by an existing pregnancy or a loss of liver function (liver cirrhosis).
Symptoms, Ailments & Signs
In most cases, portal vein thrombosis has no symptoms. It is often only noticed when complications arise, which can often be life-threatening. Some patients gradually develop varicose veins in the esophagus or stomach due to portal hypertension. This increases the risk of esophagus or stomach bleeding.
This can cause vomiting of blood or so-called tarry stools. Bleeding in the upper digestive organs typically results in black, tarry, and foul-smelling stools. The spleen is often greatly enlarged. In some patients, this leads to a painful swelling of the abdomen. Meteorism and abdominal dropsy (ascites) often occur.
The blood stasis can also cause disturbances in the intestine. Sometimes diarrhea and the so-called subileus symptoms occur. The subileus symptoms are characterized by the fact that the intestinal contents are only moved forward to a limited extent. There is a backwater in the direction of the mouth. This backlog is noticeable through nausea and a feeling of fullness. Intestinal cramps and colic also occur.
Food components are only insufficiently absorbed. The subileus represents the preliminary stage of an ileus, i.e. an intestinal obstruction. However, portal vein thrombosis rarely takes such a dramatic course. As already mentioned, there are usually no symptoms at all because a large bypass cycle develops over the course of a few weeks and months. Any existing upper abdominal complaints and enlargement of the spleen will then gradually decrease.
Diagnosis & History
Doctors have a wide variety of methods at their disposal for targeted, precise detection of portal vein thrombosis. These are used in particular after the patient has been assessed, when they describe their sometimes unspecific complaints.
The individual process technologies for the diagnosis of portal vein thrombosis are based on proven and highly complicated medical technology, which are suitable as ultrasound of the upper abdomen, computer and magnetic resonance imaging and a so-called color Doppler examination. These individual procedures for portal vein thrombosis are completed by extensive tests in the laboratory. These concern, for example, the so-called liver values in the serum and the determination of the coagulation factors in the plasma.
The course of portal vein thrombosis is accompanied by pain and swelling of the upper abdomen. Diarrhea, a persistent feeling of fullness and nausea, and in rare cases vomiting, accompany portal vein thrombosis.
In most cases, portal vein thrombosis causes no symptoms. Complications usually arise from the triggering diseases. However, accumulation of water in the abdominal cavity can occur. Furthermore, varicose veins appear in the esophagus and stomach, which in unfavorable cases can even burst and cause heavy bleeding. Since the portal vein is blocked, the blood pressure in it also rises.
This local increase in blood pressure can cause the spleen to become very enlarged and rupture. However, portal vein thrombosis often also severely impairs liver function if it is no longer supplied with enough blood. As already mentioned, most complications are caused by the underlying diseases.
Portal vein thrombosis, which is triggered by liver cirrhosis, leads much more frequently to esophagus and stomach bleeding or abdominal dropsy (ascites). Ascites is otherwise not very common with other causes. Therefore, portal vein thrombosis in connection with liver cirrhosis represents a life-threatening complication.
Severe pancreatitis, a malignant pancreatic tumor or kidney cancer can also be the cause of portal vein thrombosis. Here, too, the underlying diseases cause the majority of the complications. Therefore, the diagnosis of the underlying diseases is very important in order to be able to effectively treat a complication that occurs in the context of portal vein thrombosis.
When should you go to the doctor?
People who suffer from a general feeling of illness, malaise and inner restlessness should consult a doctor. A constant decrease in resilience, sleep disorders or the vague feeling that something might be wrong should be discussed with a doctor. Portal vein thrombosis causes a gradual increase in symptoms. There has been no symptoms for a long time. Since the course of the disease can still be fatal, a doctor’s visit should be made when the first irregularities are noticed. Vomiting blood, dizziness, a feeling of tightness in the body, swelling or problems with the blood flow should be examined and treated.
A doctor is required in the event of abnormalities in the digestive tract, changes in the complexion or peculiarities of the excretions. Cramps, pain and a loss of appetite indicate a health impairment. A doctor is needed if there is constipation, a feeling of fullness, as well as a decrease in physical performance. In the case of nausea, increased body temperature, bad breath and unwanted weight loss, a doctor’s visit is advisable. If there are changes in behavior, increased irritability or bleeding when going to the toilet, a doctor must be consulted as soon as possible. A rescue service is to be alerted as soon as disturbances of consciousness appear. In these cases, the condition is life-threatening and must be treated immediately.
Treatment & Therapy
The treatment of portal vein thrombosis opens up different variants in the course of modern medical procedures and interventions. Basically, in the case of portal vein thrombosis, the same therapy is used that is also adequate for another thrombosis.
In this regard, it is primarily a matter of dissolving the thrombus and freeing the portal vein again. In the case of portal vein thrombosis, which can affect either the entire portal vein or just a part of it, this is done using specifically selected medication. These are also referred to as anticoagulants in thrombosis therapy and are also based on marcumar and heparin in portal vein thrombosis.
In contrast to thrombosis, which can develop in various other blood vessels in the body, there is no risk of pulmonary embolism with portal vein thrombosis. Nevertheless, it is important to act as quickly as possible in order to avoid damage to the liver tissue due to insufficient blood flow. In addition, the treatment of portal vein thrombosis is based equally on alleviating the symptoms and causes of the underlying diseases.
Outlook & Forecast
A thrombosis, no matter where it is, is always a worrying event. The prognosis of portal vein thrombosis is only positive if the blood clot is noticed quickly and can be resolved promptly. If it becomes chronic, the prognosis is less good.
The problem is that portal vein thrombosis can be symptom-free. So it often goes unnoticed. In the case of non-specific symptoms such as abdominal pain or fever, it is discovered earlier. However, the discovery is often made by accident. This can delay the start of treatment. Here there is a risk that intestinal necrosis will occur in some of those affected. This can subsequently lead to peritonitis, which ends fatally due to multi-organ failure.
In portal vein thrombosis that has already become chronic, cavernous changes with subsequent portal hypertension can occur. The prognosis worsens significantly if bleeding from torn varices occurs as a complication. Since portal vein thrombosis is more likely with certain previous illnesses or hereditary components, doctors should exercise particular care during check-ups.
In only 10-40 percent of those affected, portal vein thrombosis can be corrected by therapy with blood coagulants over several months. The unfavorable prognosis for the rest of those affected can be derived from this. The chances are best if the diagnosis is made early and treatment is started early.
The prevention of portal vein thrombosis lies in particular in the fact that appropriate treatment of the causative diseases is carried out. In addition, if these pre-existing conditions are present, it is important to have regular check-ups by a specialist doctor and, above all, to pay close attention to the coagulation factors.
According to laboratory findings, these should not exceed the normally permissible parameters. This is the only way to initiate meaningful prevention of portal vein thrombosis. It is also important to drink enough to avoid portal vein thrombosis. This applies in particular to older people, who often suffer from a restricted sense of thirst.
In many cases, aftercare measures are very limited in the case of portal vein thrombosis, since the disease is usually not recognized until late and is therefore often treated at an advanced stage. Those affected should therefore consult a doctor as soon as the first signs and symptoms of the disease appear, so that there are no further complications or other symptoms.
As a rule, portal vein thrombosis cannot heal itself. Most people affected by this disease are dependent on taking various medications. The correct dosage and regular intake should always be observed in order to relieve the symptoms permanently and correctly.
Likewise, those affected should always first consult a doctor in the event of ambiguities, questions or severe side effects in order to prevent further complications. In the case of portal vein thrombosis, strenuous activities or physical activities should be avoided in order not to unnecessarily burden the body.
Most patients depend on the care and support of their own families in their everyday lives. In many cases, this can also prevent depression and other mental disorders. It is not uncommon for portal vein thrombosis to drastically reduce the life expectancy of those affected.
You can do that yourself
Once this diagnosis has been made, it is important to find out how this rare form of thrombosis came about. What diseases did they cause? How the therapy proceeds depends on the answer to this question, because the portal vein thrombosis itself often causes little or no symptoms. However, any underlying diseases can be serious and complicated.
Patients with portal vein thrombosis should monitor their blood pressure as it may be elevated due to the blocked portal vein. Even if liver-friendly diets are no longer recommended nowadays, it makes sense for portal vein thrombosis patients to avoid alcohol and foods that are too fatty. Instead of animal fats, oils with high-quality omega-3 fatty acids are recommendedsuch as linseed or walnut oil. “Empty” carbohydrates such as white bread or pasta and sweets should be avoided in the long term. If the patient is overweight, it would be desirable to reduce this excess weight and achieve normal weight. If varicose veins in the stomach have also been identified along with portal vein thrombosis, it is advisable to eat smaller meals several times a day, as they are easier to digest than three large ones.
Anything that reduces stress is also helpful. This includes regular rest periods as well as daily exercise in the fresh air. Gentle sports such as yoga, reiki, tai chi or qi gong also help to relieve stress.