Background and aim: Portal vein thrombosis (PVT) in cirrhotic patients is most commonly detected incidentally on routine ultrasound (US), but should be suspected in any patient with worsening or liver decompensation and in patients with a portal vein flow <15cm/s. Patients with acute PVT may develop or worsen ascites. The detection of multiple small vessels flow at the usual portal vein site is considered cavernous (chronic) transformation that can form in as little as 6 days. Aim. To determine the characteristics of the ascitic fluid and the portal vein flow of cirrhotic patients with PVT.
Material and methods: Research design: Descriptive, cross-sectional / prevalence. Procedure: Ascitic fluid cytology and Doppler ultrasound (DUS) results of patients admitted during 2019 were reviewed, from these all the cirrhotics with PVT were selected. The qualitative variables were expressed in frequencies and percentages and numerical variables in mean and standard deviation.
Results: Of 491 cirrhotic patients admitted to the Gastroenterology department in 2019, we found 24 cirrhotic patients with PVT (4.89%), of them regarding the composition of the ascitic fluid: the mean protein value was 1.71 gr/dl±1.37, DHL: 88.00±5.56, and glucose was 165.67±66.52. On the other hand, the mean cell count in the cytological exam of patients with PVT was 144.67±191.44. Regarding the flow characteristics in the DUS, 14 (58.3%) presented chronic characteristics reported as cavernomatosis of the portal vein. The mean flow of the portal vein was 19.04cm/s±4.71, lastly, 13 (54.2%) cirrhotic patients diagnosed with PVT 4 (16.7%) had flow less than 15cm/s.
Conclusions: In our hospital, according to the laboratory normal ranges, most patients diagnosed with PVT presented an increase in LDH and had an increase in the number of cells in the ascites fluid, and more than half were diagnosed in the late stage with recanalization and more than ten percent of these patients were at high risk for new thrombosis due to a reduced flow of the portal vein.
Conflicts of interest: The authors have no conflicts of interest to declare.
