What is hepatic vein thrombosis?
Hepatic vein thrombosis (HVT) is an obstruction in the hepatic veins of the liver caused by a blood clot.
This condition blocks the drainage system of your liver, impeding blood flow back to your heart. Without proper blood flow, your liver stops getting the fresh oxygen it needs to function. This can severely damage your liver and may lead to liver failure.
The symptoms caused by HVT vary from person to person. Some people may have no symptoms until the blockage causes liver damage.
HVT is also called Budd-Chiari syndrome.
Causes of HVT
Certain medications, diseases, and inherited disorders can cause HVT. Anything that can cause blood clotting in the veins of your liver may lead to HVT.
The most common causes of HVT are:
- inherited blood disorders
- liver cancer
- liver trauma
- vein inflammation (phlebitis)
- birth control pills
- immunosuppressant drugs
- autoimmune disorders
- inflammatory disorders
- connective tissue disorders
Symptoms of HVT
Not everyone with HVT will have noticeable symptoms in the early stages of the condition. For those who do, the most common symptoms are buildup of fluid in their abdomen and an enlarged liver. This is caused by pressure buildup behind the blockage.
Other symptoms of HVT include:
- nausea and vomiting
- vomiting blood
- unexplained weight loss
- enlarged spleen
- swelling of lower limbs
- abdominal pain (mainly in the upper right part of your abdomen)
- jaundice (yellowing of your skin and eyes)
Call your doctor if you experience any of these. Prompt treatment will prevent liver damage and give you a better outlook for recovery.
Your doctor can diagnose HVT by taking your medical history, running blood tests, and performing a physical exam.
During the exam, your doctor presses gently on your abdomen to feel for the presence of fluid or an enlarged liver.
A blood sample can show if your liver is working properly. You may need an imaging test if the blood test results show liver damage.
You may need a liver biopsy if your doctor spots abnormalities in your liver. To perform a biopsy, your doctor removes a small piece of tissue from your liver to look for damage.
Your doctor can also measure pressure within your hepatic veins. To do this, they insert a small instrument through a catheter into a vein. This procedure is called hepatic vein catheterization.
Treatment for HVT
Anticlotting medications can often treat HVT. Medications used to dissolve blood clots are called fibrinolytic drugs. Your doctor may also prescribe anticoagulants to prevent blood clots.
Your doctor may choose to widen the affected hepatic vein to improve blood flow. This procedure is called percutaneous transluminal angioplasty.
During the procedure, a surgeon feeds a catheter into the blocked vein. The catheter has a deflated balloon at its tip, which the surgeon inflates once it’s in the vein. This causes the vein to widen.
Once the vein is wide enough, the surgeon inserts wire mesh into the vein. This holds it open.
Your surgeon may use transjugular intrahepatic portosystemic shunting to redirect the blood flow away from your liver. This releases pressure on your portal vein, which is responsible for moving blood into your liver.
Future health complications and outlook
Untreated HVT can lead to liver failure. People with liver failure who don’t receive a transplant may have a three-year life expectancy.
The effectiveness of your treatment plan will depend on many factors, including:
- blockage location
- speed of treatment
- type of treatment
- the underlying cause of your HVT
HVT doesn’t always have noticeable symptoms in its early stages. You’ll have a better outlook if you get an early diagnosis and start treatment immediately.
Schedule regular checkups with your doctor and tell them if you’re experiencing symptoms you’re concerned about. This will make catching potentially serious health conditions in the early stages more likely.