The Radiology Partners (RP) National Quality and Safety Committee presents our newest Rad to Rad Learning case.
Peer Learning Opportunity
This condition will typically present with vague abdominal pain and can result in bowel ischemia, depending on extent of mesenteric vein involvement.
Portal Vein Thrombosis
Left: Bland portal vein thrombus in a non-cirrhotic patient
Right: Tumor thrombus in a patient with infiltrative hepatocellular carcinoma.
Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.
Practical Insights
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Most commonly seen in the setting of cirrhosis/portal hypertension resulting in slow flow. Also can be seem in hypercoagulable state.
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Any enhancement of the thrombus should be a clue to underlying HCC.
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In the chronic setting, can present as cavernous transformation with multiple serpiginous vessels feeding into both left and right portal vein branches.
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Vital to distinguish bland thrombus from tumor thrombus, which precludes possibility of liver transplant.
Vital to distinguish bland thrombus from tumor thrombus, which precludes possibility of liver transplant.The RP National Quality and Safety Committee is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.
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