To understand PVT, one must first understand that the liver receives blood from two sources: first the hepatic artery supplies 25% of blood to the liver, while the portal vein supplies the remaining 75%. Blood in the portal vein comes from the intestines and is processed by the liver. Portal vein thrombosis is a blockage in blood flowing from the intestines to the liver and prevents this blood from being processed. [insert image] The pathophysiology of portal vein thrombosis involves a combination of risk factors that contribute to the formation of blood clots, including hypercoagulability, injury to blood vessels, and inflammation. This condition can happen at any point in life, including in utero. This blockage, in turn, can lead to serious complications due to impaired blood flow to the liver.
The consequences of portal vein thrombosis may include portal hypertension which can lead to encephalopathy (cognitive and neurological abnormalities due to accumulation of toxins), ascites (accumulation of fluid in the abdomen), biliopathy (abnormalities in flow of bile) which can lead to liver dysfunction, bleeding from the gastrointestinal tract (due to engorgement of blood vessels), and cardiopulmonary dysfunction.
The management of portal vein thrombosis often involves addressing the underlying causes, anticoagulation therapy to prevent further clot formation, and managing complications such as portal hypertension which leads to GI bleeding, lower platelet counts, an enlarged spleen and liver disease. Treatment decisions are individualized based on the specific circumstances and underlying conditions of each patient.
To our referring physicians, we offer quaternary care for the most complex pediatric patients. For this disease process, we collaborate with you to offer recommendations and surveillance as a supplement to your practice. Here is a list of diagnostics and therapeutics at Texas Children's to serve your patients:
Hepatology
Clinical Neuropsychologist
Hematology
Advanced Ultrasonography
Endoscopy
Interventional Radiology
Physiologic Surgical Shunts
Selective Surgical Shunts
Modified Sugiura (Splenectomy and gastroesophageal devascularization)
