Ma et al reported a classification of portal vein thrombosis (PVT). The authors are from Zhongshan Hospital, Fudan University (Shanghai) and Henry Ford Hospital.
Patient selection: portal vein thrombosis
Parameters:
(1) degree of obstruction, with partial versus complete portal vein thrombosis
(2) presence or absence of a portal vein cavernoma (cavernous transformation of the portal vein due to a proliferation of collateral veins)
Degree of Obstruction
Portal Vein Cavernoma
Type
partial
absent
1
partial
present
2
complete
absent
3
complete
present
4
where:
• Cavernous transformation of the portal vein was associated with the severity of the portal vein thrombosis (more common in complete than partial occlusion). It also tends to indicate that occlusion has been present for some time.
The authors found that duration of symptoms, portal hypertension and presence of a cavernoma were unreliable for distinguishing acute from chronic portal vein thrombosis. Absence of symptoms does not exclude chronic PVT. Portal hypertension is more a reflection of underlying cirrhosis.
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