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- Title
PORTAL VEIN THROMBOSIS IN CIRRHOTIC PATIENTS - CEUS CHARACTERIZATION, INCIDENCE AND CLINICAL PRESENTATION.
- Authors
Ghiuchici, Ana-Maria; Danilă, Mirela; Popescu, Alina; Şirli, Roxana; Topan, Mădălina; Burciu, Călin; Corobea, Andreea; Sporea, Ioan
- Abstract
Aim: Portal vein thrombosis is a frequent complication of liver cirrhosis. The aim is to evaluate the frequency of PVT in cirrhosis and the sensitivity of CEUS in the characterization of PVT. Material and methods: We performed a retrospective study including 730 patients with liver cirrhosis admitted to the Department of Gastroenterology of SCJUT between January 2016-December 2017, respectively 450 men (61.6%) and 280 women (38.4%), mean age 61.7 ± 10.57 years. The parameters followed were: Child-Pugh score, presence of portal vein thrombosis, HCC. The diagnosis of portal thrombosis was determined by ultrasound examination by an expert in the field. The nature of portal vein thrombosis was assessed by contrast-enhanced ultrasound (CEUS), confirmed by another imaging method with contrast (CT scan/MRI). Results: According to the stage of the disease, the patients were Child Pugh class A-29.8%; Class B -38.9% and Class C - 31.3%. Out of the 730 patients with cirrhosis, 79 (10.8%) had portal vein thrombosis described by ultrasound. Portal vein thrombosis was complete in 35/79 patients (44.3%) and partial in 44/79 (55.7%) cases. CEUS examination of portal thrombosis showed 54 malignant portal vein thrombosis (68.3%) and 25 benign portal vein thrombosis (31.7%). 94.1% (51/54) of patients with malignant portal thrombosis had hepatocellular carcinoma. Esophageal and gastric varices were present in 61/79 patients with portal vein thrombosis (77.2%). 39.3% of these patients (24/61) had a history of upper gastrointestinal bleeding by variceal rupture p<.0001. Conclusions: Portal vein thrombosis was present in 10.8% of cirrhotic patients. CEUS is a sensitive method for the characterization of PVT in cirrhotic patients. 68.3% of cases the thrombosis was malignant and was associated with hepatocellular carcinoma. Portal vein thrombosis in patients with esophageal and gastric varices is associated with increased risk of upper gastrointestinal bleeding due to variceal rupture p<.0001.
- Subjects
PORTAL vein; THROMBOSIS; VARICOSE veins; CONTRAST-enhanced ultrasound; ESOPHAGEAL varices; CHILD patients
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p27
- ISSN
2068-3324
- Publication type
Article