Background and aim: Portal vein thrombosis (PVT) is a complication in the natural history of liver disease, a “rebalanced” coagulation system can promote bleeding or thrombotic tendency. The prevalence of PVT in cirrhosis is 1% among compensated patients and 8-25% in decompensated patients. Aim. To determine the prevalence and characteristics of cirrhotic patients with PVT.
Material and methods: Research design: Descriptive, cross-sectional / prevalence. Procedure: We analyzed medical records of patients admitted during 2019, all cirrhotics subjects with PVT were included. Qualitative variables were expressed in frequencies and percentages and numerical variables in mean and standard deviation.
Results: Of 491 cirrhotic patients hospitalized to the Gastroenterology department in 2019, we found 24 patients with PVT (4.89%), 15 (62.5%) were women, mean age was 58.13±13.51 year. 6 (25.0%) with malignancy, of those latter 6/6 (100.0%) with hepatocellular carcinoma. Regarding of cirrhosis etiology: 9 (37.5%) were of unknown cause, 6 (25.0%) ASH, 3 (12.5%) from NASH, 1 (4.2%) from hepatitis-C, 1 (4.2%) autoimmune hepatitis and 1 (4.2%) CBP. Regarding Child-Pugh: 11 (45.8%) B, and 13 (54.2%) C. Mean MELD was 21.58±9.74. Upper gastrointestinal bleeding was present in 17 (70.8%) subjects, of those 15 (88.2%) due to esophageal varices and 11 (64.7%) for esophageal-gastric varices. 5 (41.7%) presented spontaneous bacterial peritonitis (SBP). 9 (37.5%) admitted with hepatic encephalopathy. 21 (87.5%) with ascites, of those: 6 (28.6%) grade I, 12 (57.1%) grade II, only 3 (14.3%) grade III. Complementary studies in patients without acute infection: leukocytes: 8,058±4.41, creatinine 1.54±0.86, albumin: 2.5gr/dl±0.62, AST: 127 U/L±224.83, ALT: 70 U/L±107.44, ALP: 155.75 U/L±74.51, GGT: 62.58 U/L±52.04, total bilirubin: 5.41mg/dl±7.34, PT: 18.20±4.32, INR: 1.57±0.40. Regarding the location of the thrombus: 14 (58.3%) presented in the portal vein trunk, 6 (25.0%) in the trunk and its branches, and 4 (16.7%) only in one branch.
Conclusions: PVT is more frequent in cirrhotic women, decompensated cirrhosis, alcohol related and the presence of hepatocarcinoma. The most frequent location was in the portal vein trunk.
Conflicts of interest: The authors have no conflicts of interest to declare.
