Systematic review: portal vein thrombosis in cirrhosis
Article first published online: 23 OCT 2009
© 2010 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 31, Issue 3, pages 366–374, February 2010
How to Cite
TSOCHATZIS, E. A., SENZOLO, M., GERMANI, G., GATT, A. and BURROUGHS, A. K. (2010), Systematic review: portal vein thrombosis in cirrhosis. Alimentary Pharmacology & Therapeutics, 31: 366–374. doi: 10.1111/j.1365-2036.2009.04182.x
- Issue published online: 3 JAN 2010
- Article first published online: 23 OCT 2009
- Publication data Submitted 5 August 2009 First decision 25 August 2009 Resubmitted 12 October 2009 Accepted 20 October 2009 Epub Accepted Article 23 October 2009
Aliment Pharmacol Ther 31, 366-374
Background As current imaging techniques in cirrhosis allow detection of asymptomatic portal vein thrombosis during routine ultrasonography, more patients with cirrhosis are diagnosed with portal vein thrombosis. Although a consensus on noncirrhotic extra-hepatic portal vein thrombosis has been published, no such consensus exists for portal vein thrombosis with cirrhosis.
Aim To perform a systematic review of nonmalignant portal vein thrombosis in cirrhosis in terms of prevalence, pathogenesis, diagnosis, clinical course and management.
Methods Studies were identified by a search strategy using MEDLINE and EMBASE.
Results Portal vein thrombosis is encountered in 10–25% of cirrhotics. In terms of pathophysiology, cirrhosis is no longer considered a hypocoagulable state; rather than a bleeding risk in cirrhosis, various clinical studies support a thrombotic potential. Clinical findings of portal vein thrombosis in cirrhosis vary from asymptomatic disease to a life-threatening condition at first presentation. Optimal management of portal vein thrombosis in cirrhosis is currently not addressed in any consensus publication. Treatment strategies most often include the use of anticoagulation, while thrombectomy and transjugular intrahepatic portosystemic shunts are considered second-line options.
Conclusions Portal vein thrombosis in cirrhosis has many unresolved issues, which are often the critical problems clinicians encounter in their everyday practice. We propose a possible research agenda to address these unresolved issues.