Thrombosis of the Portal Venous System in Cirrhotic vs. Non-Cirrhotic Patients
Vania Cruz-Ramón, Paulina Chinchilla-López, Oscar Ramírez-Pérez, Nancy E Aguilar-Olivos, Luis F Alva-López, Ericka Fajardo-Ordoñez, Guadalupe Ponciano-Rodríguez, Patrick G Northup, Nicolas Intagliata, Stephen H Caldwell, Xingshun Qi, Nahum Méndez-Sánchez, Vania Cruz-Ramón, Paulina Chinchilla-López, Oscar Ramírez-Pérez, Nancy E Aguilar-Olivos, Luis F Alva-López, Ericka Fajardo-Ordoñez, Guadalupe Ponciano-Rodríguez, Patrick G Northup, Nicolas Intagliata, Stephen H Caldwell, Xingshun Qi, Nahum Méndez-Sánchez
Abstract
Introduction and aim: Thrombosis is a vascular disorder of the liver often associated with significant morbidity and mortality. Cirrhosis is a predisposing factor for portal venous system thrombosis. The aim of this study is to determine differences between cirrhotics and non-cirrhotics that develop thrombosis in portal venous system and to evaluate if cirrhosis severity is related to the development of portal venous system thrombosis.
Material and methods: We studied patients diagnosed with portal venous system thrombosis using contrast-enhanced computed tomography scan and doppler ultrasound at Medica Sur Hospital from 2012 to 2017. They were categorized into two groups; cirrhotics and non-cirrhotics. We assessed the hepatic function by Child-Pugh score and model for end-stage liver disease.
Results: 67 patients with portal venous system thrombosis (25 with non-cirrhotic liver and 42 with cirrhosis) were included. The mean age (± SD) was 65 ± 9.5 years in cirrhotic group and 57 ± 13.2 years (p = 0.009) in non-cirrhotic group. Comparing non-cirrhotics and cirrhotics, 8 non-cirrhotic patients showed evidence of extra-hepatic inflammatory conditions, while in the cirrhotic group no inflammatory conditions were found (p < 0.001). 27 (64.29%) cirrhotic patients had thrombosis in the portal vein, while only 9 cases (36%) were found in non-cirrhotics (p = 0.02).
Conclusions: In cirrhotic patients, hepatocellular carcinoma and cirrhosis were the strongest risk factors to develop portal venous system thrombosis. In contrast, extrahepatic inflammatory conditions were main risk factors associated in non-cirrhotics. Moreover, the portal vein was the most frequent site of thrombosis in both groups.
Keywords: Cirrhosis. Portal vein. Thrombus. Predictive factor. Hepatocellular carcinoma..
Source: PubMed