Liver and intrahepatic bile ducts - nontumor
Vascular disorders
Portal vein obstruction

Author: Raul S. Gonzalez, M.D.
Deputy Editor Review: Debra Zynger, M.D.

Revised: 7 March 2018, last major update February 2018

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Portal vein obstruction[TI] liver

Cite this page: Gonzalez, R.S. Portal vein obstruction. website. Accessed March 21st, 2018.
Definition / general
  • Blockage of blood flow through the portal vein into the liver
Essential features
  • Malignant and nonmalignant processes may cause portal vein obstruction
  • Portal hypertension commonly results
  • Biliary abnormalities may also occur
  • Terminology
    • Portal vein obstruction leading to splenomegaly and anemia is termed "Banti syndrome"
    • Portal vein obstruction may cause a sclerosing cholangitis-like clinical picture termed "portal biliopathy" (World J Gastroenterol 2012;18:6177, Gut 1992;33:272
    • Relatively rare
    • Hepatic artery buffer response allows for increased arterial flow to liver when portal vein is obstructed
    • Prothrombotic disorders (BMC Gastroenterol 2007;7:34), tumor thrombus, cirrhosis, pancreatitis, various infections (e.g. schistosomiasis)
    • Intra-abdominal infection and appendicitis are common causes in children
    • May be idiopathic
    Clinical features
    • Signs / symptoms:
      • Abdominal pain
      • Ascites (massive, intractable)
      • Portal hypertension
      • Bowel infarction
    Radiology description
    Radiology images

    Images hosted on other servers:

    Pancreatic mass and portal vein thrombosis

    Case reports
    Gross images

    Images hosted on other servers:

    Tumor thrombus causing portal vein obstruction

    Board review question #1
    A patient develops portal vein thrombosis secondary to appendicitis. Based on this information, which of the following is most likely true regarding the patient?

    1. Has an allograft liver
    2. Has situs inversus
    3. Has von Willebrand disease
    4. Is a child
    5. Is a woman
    Board review answer #1
    D. Is a child