Document Detail


Chronic portal vein thrombosis: transcapsular hepatic collateral vessels and communicating ectopic varices.
MedLine Citation:
PMID:  20829527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess patients with chronic portal vein thrombosis (PVT) with respect to transcapsular collateral veins, the communication between these veins and ectopic varices, and the cause of PVT.
MATERIALS AND METHODS: This study was approved by the institutional review committees, and written informed consent was obtained. From November 2003 to March 2008, 145 consecutive patients with chronic PVT due to a variety of causes were assessed for transcapsular collaterals and ectopic varices with ultrasonography (US). Analysis of contingency tables was performed with the Fisher exact test.
RESULTS: Transcapsular collaterals were detected in 15 (10.3%) of 145 patients with chronic PVT. They were restricted to patients with a history of hepatobilary surgery, severe pancreatitis, or abdominal surgery (n = 21) and were not detected in patients with liver cirrhosis, systemic coagulopathy, extrahepatic malignancy, idiopathic PVT, chronic pancreatitis, or infectious or inflammatory diseases (n = 124) (P < .001). Ectopic varices were infrequent in 70 patients with liver cirrhosis (n = 2, 3%) but were common in 14 patients with PVT after hepatobiliary surgery (n = 9, 64%) (P < .001, odds ratio = 21.4). Direct communication between transcapsular collaterals and ectopic varices was visible in all nine patients in this cohort. In eight of these patients, ectopic varices were found to be the bleeding source in gastrointestinal hemorrhage.
CONCLUSION: Transcapsular collaterals frequently occur in patients with chronic PVT due to hepatobilary surgery or necrotizing pancreatitis. They are associated with ectopic varices; therefore, awareness of transcapsular collaterals in this patient subgroup will help to localize ectopic varices as potential bleeding source.
Authors:
Marcus Seeger; Rainer Günther; Holger Hinrichsen; Marcus Both; Ulf Helwig; Alexander Arlt; Birte Stelck; Jan H Bräsen; Bence Sipos; Clemens Schafmayer; Felix Braun; Dieter C Bröring; Stefan Schreiber; Jochen Hampe
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Publication Detail:
Type:  Journal Article     Date:  2010-09-09
Journal Detail:
Title:  Radiology     Volume:  257     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-20     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  568-78     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010.
Affiliation:
Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. mseeger@1med.uni-kiel.de
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Collateral Circulation
Contrast Media / diagnostic use
Humans
Liver / blood supply*
Magnetic Resonance Imaging
Phospholipids / diagnostic use
Portal Vein / surgery,  ultrasonography*
Portasystemic Shunt, Transjugular Intrahepatic
Prognosis
Sulfur Hexafluoride / diagnostic use
Tomography, X-Ray Computed
Varicose Veins / surgery,  ultrasonography*
Venous Thrombosis / surgery,  ultrasonography*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Phospholipids; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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