Trombosis de la vena porta: A propósito de 4 casos en el hospital militar Dr. Carlos Arvelo

La trombosis venosa portal es una oclusion de la misma por un coagulo y/o trombo; o por otras causas como cirrosis, cancer de higado, pancreas o estomago. Afecta unicamente al tronco portal. En ausencia de un tumor maligno que invada o comprima el eje esplenoportal, la trombosis es el mecanismo etiopatogenico mas frecuente que ocasiona la obstruccion venosa. Segun las series estudiadas en un 7%-22% de los pacientes con trombosis portal no se identifica una condicion protrombotica (trombosis portal idiopatica). No obstante, en el resto de ocasiones en un 40% de casos existe un factor local desencadenante y en un 60% de casos restantes factores trombogenicos sistemicos. En mas de un 15 % de estos pacientes coexisten factores etiologicos multiples. Las consecuencias clinicas de la trombosis venosa del eje esplenoportal dependen del momento evolutivo en el que se encuentre esta, pero tambien de la extension del trombo. La principal manifestacion suele ser el dolor abdominal, con frecuencia irradiado a espalda. Pueden aparecer sintomas inespecificos como fiebre sin foco conocido, sintomas dispepticos (nauseas y plenitud postprandial) y malestar general. Los parametros de funcion hepatica, albumina y tiempo de protrombina muestran minimas alteraciones. En este trabajo quisimos exponer 4 casos de pacientes de nuestro centro a los cuales se les realizo el diagnostico de trombosis de la vena porta, con edades comprendidas entre 30-60 anos, con predominio del sexo masculino, y quienes han cumplido regularmente su tratamiento no presentando complicaciones durante su evolucion, manteniendose estables en su control entre 2003 y 2009... Portal vein thrombosis is its occlusion by a clot and/or thrombus, or by other causes such as cirrhosis, cancer of liver, pancreas or stomach. It affects the portal trunk only. Whenever a malignant tumor invading or compressing the splenoportal axis is not present, thrombosis is the most frequent ethiopathogenetic mechanism causing vein obstruction. According to the studied series, in 7-22% of patients with portal thrombosis no prothrombotic condition (idiopathic portal thrombosis) is identified. However, in 40% of the remaining cases there is a local triggering factor, and the other 60% shows systemic thrombogenetic factors. Multiple etiologic factors coexist in over 15% of said patients. The clinical consequences of the splenoportal axis vein thrombosis depend on the evolution momentum where the thrombosis is found, and also on the thrombus' dimension. Abdominal pain could be the main manifestation, frequently irradiated to the back. Non-specific symptoms could appear, such as fever of unknown origin, dyspeptic symptoms (nausea and postprandial fullness), and general malaise. The parameters of hepatic function, albumin, and of prothrombin time show minimal changes. In this study the cases of 4 patients of this health center were exposed; said patients were diagnosed with portal vein thrombosis and were of ages ranging 30-60, male-sex prevalence, who regularly followed their treatment and did not present complication in their evolution, staying stable in their 2003 and 2009 control...