Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.20140063
Jornal Vascular Brasileiro
Case Report

Management and conduct of vascular diseases of the portal system

Manejo e conduta das doenças vasculares do sistema porta

Lenon Cardoso; Thiago Cerizza Pinheiro; Maissa Marçola Scandiuzzi; Fernanda Soares Simoneti; Daniel Ilias; Marlon Moda; Ronaldo Antônio Borghesi

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Abstract

Aneurysms and thromboses of the portal vein are rare pathologies of the portal system that commonly follow an asymptomatic course. The vast majority of cases are diagnosed as incidental findings during imaging studies. Symptoms of aneurysms are the result of mass effects, while thrombosis symptoms are a function of the liver's ability to form a collateral circulation network in the thrombosis. The scant experience with such cases poses a dilemma for patient management and so the vast majority of authors choose an expectant approach with rigorous patient surveillance and only intervene in symptomatic patients. We report one case of an aneurysm of the portal vein and one case of portal vein thrombosis and discuss management and observation of these patients.

Keywords

thrombosis, aneurysm, portal system

Resumo

O aneurisma e a trombose de veia porta são doenças raras do sistema porta, que comumente cursam sem sintomas. A grande maioria dos pacientes é diagnosticada com achados em exames de imagem. Os sintomas são atribuídos ao efeito de massa, no caso do aneurisma, e relativos à capacidade hepática de formar uma rede de circulação colateral, no caso da trombose. A escassa experiência nesses casos representa um dilema na abordagem desses pacientes e, portanto, a grande maioria dos autores opta por seguimento rigoroso e a intervenção é indicada apenas para os pacientes sintomáticos. Neste trabalho, relatamos um caso de aneurisma de veia porta e outro de trombose da veia porta, propondo o manejo e o acompanhamento desses pacientes.

Palavras-chave

trombose, aneurisma, sistema porta

References

Gillespie DL, Villavicencio JL, Gallagher C, Chang A, Hamelink JK, Fiala LA. Presentation and management of venous aneurysms. J Vasc Surg.. ;26(5):845-52.

Mucenic M, Rocha MS, Laudanna AA, Cançado ELR. Treatment by splenectomy of a portal vein aneurysm in hepatosplenic schistosomiasis. Rev Inst Med Trop Sao Paulo.. ;44(5):261-64.

Vyas S, Mahajan D, Sandhu MS, Duseja A, Khandelwal N. Portal vein aneurysm: is it an incidental finding only?. Ann Hepatol.. ;11(2):263-64.

Barzilai R, Kleckner MS Jr. Hemocholecyst following ruptured aneurysm of portal vein: report of a case. AMA Arch Surg.. ;72(4):725-27.

Ma R, Balakrishnan A, See TC, Liau SS, Praseedom R, Jah A. Extra-hepatic portal vein aneurysm: A case report, overview of the literature and suggested management algorithm. Int J Surg Case Rep.. ;3(11):555-58.

Andraus W, Amico EC, Machado MA, Bacchella T, Machado MCC. Portal vein aneurysm. Clinics (Sao Paulo).. ;62(2):203-05.

Bayraktar Y, Harmanci O. Etiology and consequences of thrombosis in abdominal vessels. World J Gastroenterol.. ;12(8):1165-174.

Balfour, G.; Stewart, T. Case of enlarged spleen complicated with ascites, both depending upon varicose dilatation and thrombosis of the portal vein. Med J. Edinburgh.. ;14:589-98.

Belli L, Romani F, Riolo F, Rondinara G, Aseni P, Di Stefano M, et al. Thrombosis of portal vein in absence of hepatic disease. Surg Gynecol Obstet.. ;169(1):46-9.

Ponziani FR, Zocco MA, Campanale C, Rinninella E, Tortora A, Di Maurizio L, et al. Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment. World J Gastroenterol.. ;16(2):143-55.

Valla DC, Condat B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. J Hepatol.. ;32(5):865-71.

Harmanci O, Bayraktar Y. Portal hypertension due to portal venous thrombosis: etiology, clinical outcomes. World J Gastroenterol.. ;13(18):2535-540.

Alves RLJ, Macedo FA, Latorre MV, de Paula BHR, Barradas F, Tavares M. Trombose de veia porta: revisão de literatura e relato de caso. Cadernos UniFOA.. ;7(18):101-08.

Schettino GCM, Fagundes EDT, Roquete MLV, Ferreira AR, Penna FJ. Trombose de veia porta em crianças e adolescentes. J Pediatr.. ;82(3):171-78.

Sfyroeras GS, Antoniou GA, Drakou AA, Karathanos C, Giannoukas AD. Visceral venous aneurysms: clinical presentation, natural history and their management: a systematic review. Eur J Vasc Endovasc Surg.. ;38(4):498-505.

Lall P, Potineni L, Dosluoglu HH. Complete spontaneous regression of an extrahepatic portal vein aneurysm. J Vasc Surg.. ;53(1):206-08.

Qi X, Han G, Bai M, Fan D. Stage of portal vein thrombosis. J Hepatol.. ;54(5):1080-2, author reply 1082-3.

Simão A, Correia L, Carvalho A, Costa N. Trombose da veia porta: importância do diagnóstico e tratamento precoces. Liver Today: Boletim Informativo APEF.. ;7:4-5.

Boyer TD. Management of portal vein thrombosis. Gastroenterol Hepatol.. ;4(10):699-700.

Condat B, Pessione F, Helene Denninger M, Hillaire S, Valla D. Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology.. ;32(3):466-70.

Janssen HL, Wijnhoud A, Haagsma EB, van Uum SH, van Nieuwkerk CM, Adang RP. Extrahepatic portal vein thrombosis:aetiology and determinants of survival. Gut.. ;49(5):720-24.

Piscaglia F, Gianstefani A, Ravaioli M, Golfieri R, Cappelli A, Giampalma E. Criteria for diagnosing benign portal vein thrombosis in the assessment of patients with cirrhosis and hepatocellular carcinoma for liver transplantation. Liver Transpl.. ;16(5):658-67.

Englesbe MJ, Kubus J, Muhammad W, Sonnenday CJ, Welling T, Punch JD. Portal vein thrombosis and survival in patients with cirrhosis. Liver Transpl.. ;16(1):83-90.

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