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Gastroenterología y Hepatología (English Edition) Portal vein thrombosis in the absence of cirrhosis: Diagnostic and therapeutic a...
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Vol. 48. Issue 9.
(November 2025)
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Vol. 48. Issue 9.
(November 2025)
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Portal vein thrombosis in the absence of cirrhosis: Diagnostic and therapeutic approach in clinical practice
Trombosis portal no cirrótica: abordaje diagnóstico y terapéutico en práctica clínica
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Asunción Ojedaa,b,1, Arantxa Gelabertc,1, Virginia Hernández-Geaa,b,d,
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vihernandez@clinic.cat

Corresponding authors.
, Juan Carlos García-Pagána,b,d,
Corresponding author
jcgarcia@clinic.cat

Corresponding authors.
a Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Clínic Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-RareLiver), CSUR Centro de referencia del Sistema Nacional de Salud en Enfermedad Hepática Compleja, Barcelona, Spain
b Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), CIBEREHD (Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas), Barcelona, Spain
c Department of Interventional Radiology, Hospital Clínic, Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
d Departament de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
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Table 1. Risk factors associated with NC-NT PVT.
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Abstract

Non-cirrhotic non tumoral portal vein thrombosis is an entity of low prevalence but with a potential risk of developing complications of portal hypertension, which has a significant prognostic impact on patients. In the absence of liver cirrhosis, it is essential to rule out other chronic liver disease as well as local factors and prothrombotic conditions. Therefore, a thorough workup should be initiated immediately. In acute thrombosis, anticoagulation is the main treatment to prevent progression of thrombosis and development of intestinal ischemia. In chronic forms, however, close follow-up is essential to prevent and treat complications of portal hypertension. For refractory complications of portal hypertension, endovascular recanalization techniques have promising results and are becoming increasingly important.

Keywords:
Portal vein thrombosis
Portal hypertension
Anticoagulation
Recanalization
Endovascular treatment
Resumen

La trombosis portal no cirrótica y no tumoral es una entidad de baja prevalencia, pero con potencial riesgo de desarrollar complicaciones de la hipertensión portal, lo que conlleva un impacto pronóstico significativo en estos pacientes. En ausencia de cirrosis, es esencial descartar otras enfermedades hepáticas crónicas, factores locales y condiciones protrombóticas por lo que se debe realizar una evaluación diagnóstica exhaustiva. En la trombosis portal aguda, la anticoagulación es el principal tratamiento para prevenir la progresión de la trombosis y el desarrollo de isquemia intestinal. Sin embargo, en las formas crónicas, es esencial un seguimiento estrecho para prevenir y tratar las complicaciones de la hipertensión portal. En caso de desarrollar complicaciones de la hipertensión portal refractarias al tratamiento, las técnicas endovasculares de recanalización portal están adquiriendo cada vez mayor relevancia y cuentan con resultados prometedores.

Palabras clave:
Trombosis portal
Hipertensión portal
Anticoagulación
Recanalización
Tratamiento endovascular
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