Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis

doi:10.4254/wjh.v16.i5.751

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May 27, 2024 (publication date) through Mar 5, 2026

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Hepatol. May 27, 2024; 16(5): 751-765
Published online May 27, 2024. doi: 10.4254/wjh.v16.i5.751

Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis

Dhiraj Tripathi, Adam J Willington

Adam J Willington, Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom

Dhiraj Tripathi, Department of Hepatology, University Hospitals Birmingham, Birmingham B15 2TH, United Kingdom

Author contributions: Willington AJ wrote the manuscript; Willington AJ and Tripathi D equally contributed to the concept and revising the manuscript.

Supported by Speaker honorarium from WL Gore & Associates.

Conflict-of-interest statement: Adam J Willington – no conflicts of interest. Dhiraj Tripathi – Speaker honorarium from WL Gore & Associates.

Corresponding author: Dhiraj Tripathi, FRCP, MD, Professor, Department of Hepatology, University Hospitals Birmingham, Mindelsohn Way, Birmingham B15 2TH, United Kingdom. dhiraj.tripathi@uhb.nhs.uk

Received: November 17, 2023
Revised: February 20, 2024
Accepted: April 8, 2024
Published online: May 27, 2024
Processing time: 186 Days and 12.2 Hours

Abstract

Non-cirrhotic non-malignant portal vein thrombosis (NCPVT) is an uncommon condition characterised by thrombosis of the portal vein, with or without extension into other mesenteric veins, in the absence of cirrhosis or intra-abdominal malignancy. Complications can include intestinal infarction, variceal bleeding and portal biliopathy. In this article, we address current concepts in the management of NCPVT including identification of risk factors, classification and treatment, and review the latest evidence on medical and interventional management options.

Keywords: Non-cirrhotic portal vein thrombosis; Portal vein; Mesenteric veins; Venous thrombosis; Portal hypertension

Core Tip: The successful management of patients with non-cirrhotic non-malignant portal vein thrombosis (NCPVT) requires clinicians to diagnose and classify the condition correctly, meticulously identify underlying risk factors and select the appropriate treatment strategies based on the latest supporting evidence. Herein we provide a comprehensive review of current concepts in the management of NCPVT with suggested management algorithms.