Portal Vein Obstruction

  • Portal Vein Obstruction is a type of prehepatic circulatory disorder of the liver which can be initiated by a number of etiologies. Obstruction of the portal vein usually is a result of total or partial thrombosis which can develop suddenly or insidiously, over time.
Common Etiologies
  • Hepatocellular Carcinoma: Invasive hepatocellular carcinoma frequently invades into the branches of the portal vein and can often extend directly into the portal vein itself, initiating thrombosis.
  • Acute Pancreatitis: Pancreatitis can initiate thrombosis of the splenic vein that can then extend into the portal vein.
  • Surgery: Surgery in the general vicinity of the portal vein can initiate post-surgical thromboses.
Clinical Consequences
  • Ascites may arise due to generation of portal hypertension behind the obstruction.
  • Splenomegaly may occur due to the buildup of obstructed blood within the spleen.
  • Esophageal Varices can also develop if obstruction exists on a chronic timescale.