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

Author: Raul S. Gonzalez, M.D.

Revised: 21 February 2018, last major update February 2018

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

PubMed Search: Portal vein obstruction[TI] liver

Cite this page: Gonzalez, R.S. Portal vein obstruction. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/liverportalveinobstruction.html. Accessed February 25th, 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
    Epidemiology
    • Relatively rare
    Pathophysiology
    • Hepatic artery buffer response allows for increased arterial flow to liver when portal vein is obstructed
    Etiology
    • 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 include:
      • Abdominal pain
      • Ascites (massive, intractable)
      • Portal hypertension
      • Bowel infarction
    Treatment
    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?

    1. The patient has an allograft liver
    2. The patient has situs inversus
    3. The patient has von Willebrand disease
    4. The patient is a child
    5. The patient is a woman
    Board review answer #1
    D. The patient is a child