Portal vein thrombosis associated with cirrhosis: clinical importance
I. J. Sarfeh
A group of 86 cirrhotics undergoing therapeutic variceal decompressive
procedures were studied. Patients with portal vein thrombosis (PVT)
comprised 21% of the group and more frequently had uncontrollable
hemorrhage at an earlier stage of liver disease. Mortality in the 18
cirrhotics with PVT was higher (56%), mostly as a result of rebleeding.
Despite adjustments for stage of liver disease and type of operation, in no
cirrhotic with PVT did postshunt encephalopathy develop, compared with 32%
incidence in patients without PVT (P less than .05). It is concluded that
patients with cirrhosis and PVT represent a different subpopulation of
cirrhotics. Once adequate variceal decompression has been achieved, their
prognosis should be superior to cirrhotics without PVT because their
hepatic hemodynamics are unaffected by total shunting, hence precluding
further impairment of liver function as a result of acute reduction of
hepatic blood flow.
