Liver histological changes in portal vs hepatic vein thrombosis?

[soxman]

So I understand that if the hepatic vein had a thrombus, the pressures would go high, cause varicies and can cause ascites, etc. But when a thrombus develops in the portal vein, everything seems similar to what happens when the hepatic vein is thrombosed except that the liver cells appear normal (compared to histological changes in hepatic vein thrombosis). I also don't get that of the liver cells appear normal in portal thrombosis how come there is ascites with that?
Thanks!!

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[HelpPleaseMD]

So I understand that if the hepatic vein had a thrombus, the pressures would go high, cause varicies and can cause ascites, etc. But when a thrombus develops in the portal vein, everything seems similar to what happens when the hepatic vein is thrombosed except that the liver cells appear normal (compared to histological changes in hepatic vein thrombosis). I also don't get that of the liver cells appear normal in portal thrombosis how come there is ascites with that?
Thanks!!

As far as I am aware of, ascites is just the accumulation of fluid within the peritoneal cavity. So.... thrombosis of the portal vein will lead to a build up of hydrostatic pressure within the mysenteric veins leading to an increase in extravasation of fluid into the interstitial space.

 

[soxman]

Great. Thanks for clearing that !

 

[medstud87]

I'm sure you've figured this out but clinically, you have no hepatomegaly with portal vein thrombosis vs hepatomegaly with hepatic vein thrombosis

 

[Belleza156]

I did a question on Uworld today on that same concept.....in case you haven't seen the question its Q 1701...I'd copy paste if uworld would let me.

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