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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 2/2013

01-02-2013 | Liver (B Bacon, Section Editor)

Portal Vein Thrombosis: Should Anticoagulation Be Used?

Authors: Stephen E. Congly, Samuel S. Lee

Published in: Current Gastroenterology Reports | Issue 2/2013

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Abstract

Portal vein thrombosis (PVT) can contribute to significant morbidity and mortality; in patients with cirrhosis, this can make transplant more technically challenging. Additionally, the clot may extend further into the mesenteric and splenic veins, and disturbance of the hepatic blood flow may lead to faster progression of the cirrhosis. Development of PVT is associated with local risk factors, and many patients have associated systemic prothrombotic factors. Anticoagulation in noncirrhotic patients should be initiated at diagnosis, using low-molecular-weight heparin overlapping with vitamin K antagonists. Cirrhotic patients with PVT should be screened for varices and then anticoagulated with low-molecular-weight heparin for at least a 6-month period. All patients should be assessed for triggering factors and tumors, as well as systemic prothrombotic factors. Newer evidence suggests that prophylactic anticoagulation in patients with cirrhosis may have a role in clinical management with decreased incidence of PVT and improved survival; further study is needed.
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Metadata
Title
Portal Vein Thrombosis: Should Anticoagulation Be Used?
Authors
Stephen E. Congly
Samuel S. Lee
Publication date
01-02-2013
Publisher
Current Science Inc.
Published in
Current Gastroenterology Reports / Issue 2/2013
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-012-0306-0

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