Management of Portal/Mesenteric Vein Occlusion

Valla: Patients without cirrhosis must be discussed differently from those with cirrhosis. In patients without cirrhosis, a general risk factor for venous thrombosis (a prothrombotic condition) is present in one third of the patients in whom a local factor is shown. Therefore, finding a disorder in the abdomen or pelvis should not preclude a comprehensive investigation for underlying general risk factors. Indeed, some of these risk factors can be corrected, though specific treatment means are required. In patients with cirrhosis, the investigation should be discussed according to the extension of the thrombus and the severity of liver disease. A partial portal vein thrombus in a patient with an advanced liver disease is likely to be explained merely by liver disease, so that a comprehensive work-up would not be cost-effective. In contrast, patients with extensive superior mesenteric vein involvement should be investigated for underlying prothrombotic conditions. Similarly, patients with compensated cirrhosis should be investigated for prothrombotic conditions when they develop PVT, regardless of the extent of the latter. Indeed, finding strong prothromQuestion 1: Splanchnic vein thrombosis (SVT) may affect the portal vein (portal vein thrombosis (PVT)), the splenic vein (splenic vein thrombosis (SpVT)), and/or the intestinal veins (mesenteric vein thrombosis (MVT)) either isolated or in different combinations. How do you assess the dimension of SVT, and which symptoms/signs induce the diagnostic steps?