The vascular liver disorderliness fall out due to closure of blood vessel involved and are ordinarily rare . The lesions can be separate into pre - hepatic , hepatic and post - hepatic wound . Portal nervure thrombosis is a pre - hepatic lesion , whereas , cardiac hepatopathy is an example of post - hepatic lesion . The hepatic lesions are further subdivide into pre - sinusoidal ; e.g. obliterative portal venopathy , sinusoidal ; for instance sinusoidal obstructer syndrome and post - sinusoidal lesions ; for instance being Budd - Chiari syndrome . visceral nervure thrombosis is used to delineate the combination of Budd - Chiari syndrome , portal vena thrombosis , mesenteric vein thrombosis and/or lienal vena thrombosis .
Hepatic vein thrombosis , also get it on as Budd - Chiari syndrome , is thrombus ( blood clot ) formation in the primary hepatic vein . It is the obstruction of the hepatic venous outflow include the modest hepatic veins to the entire hepatic and supra - hepatic inferior vena cava . Hepatic vein thrombosis occurs in 1 out of 100,000 hoi polloi and ordinarily occurs in female more than in males .
What Causes Hepatic Vein Thrombosis?
The aetiology of hepatic vena thrombosis can be roughly divided into principal and secondary etiology , although about 30 to 50 % of the cases of hepatic vena thrombosis are idiopathic , i.e. they do not have any identifiable suit . Primary hepatic vein thrombosis occurs due to obstacle of intra - luminal wound such as thrombosis and/or endophlebitis . The main etiological divisor in primary hepatic vein thrombosis is myeloproliferative disorder that is present in about 40 to 50 % of individuals . Secondary hepatic nervure thrombosis occurs due to extra luminal concretion by outside structures such as due to cysts , abscess or tumour . Other cause of hepatic vena thrombosis are usually inherited or acquired thrombophilia .
In the innate hepatic vein thrombosis , an someone is born with disfigurement of hepatic nervure and thus could guide to the disorder and nowadays in childhood .
Thrombosis could occur due to blood clotting disorder such as want of protein C , protein S and/or phospholipid syndrome .
Hepatic nervure thrombosis could also occur due to drugs such as oral contraceptives , immunosuppressants and/or pyrrolizidine alkaloid ( found in sealed herb such as comfrey and borage ) .
It can also come about due to an trauma / injury to hepatic vein that might conduct to rakehell coagulum in hepatic vein .
Excessive and prolonged picture of hepatic vein to radiation might also lead to hepatic vein thrombosis such as irradiation therapy for cancers .
Hepatic vein thrombosis can also be get due to certain tumors that might compress hepatic vein head to blood clot geological formation in hepatic vena . The cancers that are normally colligate with it are liver , kidney , bile duct , pancreas and adrenal cancers .
sure aesculapian disorder such as thrombophilia , sickle cell anemia , Behcet ’s syndrome , and paroxysmal nocturnal hemoglobinuria also increase the tendency of stemma to thicken , thus increasing the chance of bloodline clot formation in hepatic vein .
Hepatic vein thrombosis can also be seen in infections such as TB as well as in pregnant woman .
Symptoms of Hepatic Vein Thrombosis
Hepatic vena thrombosis has a classic triad ofhepatomegaly(enlargement of liver),ascites(fluid accumulation in the abdomen ) andabdominal pain(present mostly in the upper right quarter-circle of the abdomen ) . It can wander from being asymptomatic to presenting withliver failure . Other symptoms includenausea , puking , haematemesis , sudden epigastric pain , splenomegaly , abdominal collateral nervure distention , jaundice , esophageal varices and tendency to phlebotomise , lower extremity swelling , portal hypertension , unexplained weight red and/or encephalopathy .
Diagnosis And Treatment
The diagnosis is done found on medical history , physical exam , and blood examination include liver function tests . The classic diagnosis is done using imaging such asultrasound , CT scan , anMRIand on juncture a liver biopsy is point .
The treatment of hepatic vein thrombosis includes identification of cause and management of symptoms with the purpose of reducing fluid accumulation in the stomach and leg with the supporter of urine pill . Anticoagulation therapy , thrombolysis , angioplasty , transjugular intrahepatic portosystemic shunt ( TIPS ) , operative shunts and liver transplant are all part of direction of hepatic vein thrombosis . The advances in management have improved the outcome in hepatic vein thrombosis with a 90 % five - class natural selection rate .
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