The role of anticoagulation in pylephlebitis

Baril, Nicole; Wren, Sherry M.; Radin, Randall; Ralls, Philip W.; Stain, Steven A.

doi:10.1016/s0002-9610(96)00220-6

Cited by 170 publications

(158 citation statements)

References 14 publications

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“…110,111 Outcome of PVT is generally good and mortality primarily is due to underlying cause and less to consequences of portal hypertension. Acute PVT usually has a good prognosis when treated before the occurrence of intestinal infarction.…”

Section: Acute Non-cirrhotic Portal Vein Thrombosismentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

151

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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Section: Acute Non-cirrhotic Portal Vein Thrombosismentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

151

147

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“…The diagnosis of pylephlebitis is frequently delayed and requires a high index of suspicion in view of its non-specific clinical presentation and high mortality rate (25%) [1][2][3] . The most common findings include fever, abdominal pain and abnormal liver function tests [4,5] .…”

Section: Discussionmentioning

confidence: 99%

“…However, no underlying etiology may be identified in up to 70% of cases [4] . Blood cultures may be used to guide antibiotic therapy (positive in 23-88% of cases) [1,2] . The most common associated organisms include Bacteroides fragilis, followed by Escherichia coli, Viridans streptococci, Proteus mirabilis and Klebsiella pneumoniae [3,5,11] .…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study by Kanellopoulou et al patients treated with anticoagulation in addition to standard antibiotic therapy showed better outcome [9] . Previous studies reported benefit limited only to patients with thrombosis extending beyond the portal vein [13] , or lack of outcome differences all together [1] . Based on the most recent evidence, anticoagulation for 3-6 months should be considered to prevent extension of thrombosis and favor recanalization (reported in up to 92.6% of patients) [8] .…”

Section: Discussionmentioning

confidence: 99%

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Acute Infective Portal Vein Thrombosis Secondary to Acute Sigmoid Diverticulitis

Cheesman

Gremida

Burton

2015

Journal of Gastroenterology and Hepatology Research

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Infective thrombosis of the portal vein may complicate any infectious process of the abdominal portion of the gastrointestinal tract. The diagnosis requires a high index of suspicion, and the most common findings include fever, abdominal pain and abnormal liver function tests. Abdominal CT scan is the preferred diagnostic modality. Treatment should be initiated immediately, including empiric use of antibiotics and concomitant anticoagulation in view of the high mortality rate.

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“…Nei casi di PVT senza infarto intestinale e a paziente emodinamicamente stabile, la terapia più frequentemente adottata e consigliata è quella che prevede l'uso dell'eparina sia non frazionata sia frazionata, seguita da terapia anticoagulante con warfarin [22][23][24][25][26][27] . La ricanalizzazione del circolo portale in questi casi viene descritta nel 50-80% dei pazienti a fronte di una totale assenza di ricanalizzazione nei pazienti non trattati.…”

Section: Quali Indagini Dovrebbero Essere Fatte Successivamente?unclassified

Portal vein thrombosis

et al. 2005

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Acute portal vein thrombosis (PVT) is un uncommon disease that can be seen in the Emergency Department. In the emergency department setting the diagnosis is difficult because of the variety of clinical presentation but in some clinical presentation patterns the diagnosis should be suspected. Regard to the appropriate radiological abdominal images, color flow Doppler ultrasonography can diagnose the fresh thrombus and spiral CT may be complementary in the diagnosis. The diagnosis differentiation between acute and chronic portal vein thrombosis is important for therapeutic management and prognosis. In stable patient the most common therapy is heparin and warfarin but in some cases thrombolysis can be the treatment of choice. In the patients with intestinal infarction the surgical therapy is strongly indicated. Two cases , one of acute and the other of chronic PVT, are presented and discussed

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The role of anticoagulation in pylephlebitis

Cited by 170 publications

References 14 publications

Portal Vein Thrombosis

Portal Vein Thrombosis

Acute Infective Portal Vein Thrombosis Secondary to Acute Sigmoid Diverticulitis

Portal vein thrombosis

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