The portal vein carries blood from the entire bowel and spleen to the liver. Portal vein hypertension occurs when the blood flow in this vein is obstructed. This occurs in patients with chronic liver disease and cirrhosis wherein the blood flow to the liver is impeded due to a hardened liver. In some patients, portal vein hypertension may occur due to blood clots in the portal vein or veins of the spleen and bowel. Portal vein hypertension leads to development of multiple dilated veins in the stomach, esophagus, and rectum, which can rupture and cause vomiting of blood or blood in the stools.
Dilated veins are usually treated with banding or sclerotherapy. However, in patients who do not respond to the usual treatment, interventional radiology offers minimally invasive treatments, including placement of a Transjugular Intrahepatic Porto-systemic shunt (TIPS) and Variceal Embolization.
During TIPS, the portal vein in the liver is directly connected to a liver vein, thus relieving the obstruction to the blood flow in the portal vein. During direct vatical embolization, the dilated veins are cannulated and treated by occluding them or by sclerotherapy. In patients who have blood clots in the portal vein, bowel veins, or splenic vein, interventional radiology offers special procedures to open these vessels.
Portal vein hypertension can also lead to fluid accumulation in the abdomen. This is usually treated with oral medications. Patients who do not respond to oral medications often require repeated removal of the fluid (also known as paracentesis). TIPS is of great help in reducing the need for repeated paracentesis in such patients. Additionally, in patients who are not eligible for TIPS, interventional radiology offers a specialized procedure called “peritoneo-venous shunt” that helps reduce fluid accumulation.
To meet with an interventional radiologist at UT Southwestern's facilities in Dallas, or for more information about our services, request an appointment or call 214-645-8300.