Cavernous degeneration of portal vein involves the left and right branches of the liver.

The primary diseases of patients should be cirrhosis and portal hypertension.

The cavernous transformation of portal vein does not need special treatment now, because splenectomy and devascularization have been done.

If there are symptoms such as bleeding in the later stage, treatment such as vascular embolization can be considered, and some patients may have biliary tract compression leading to jaundice.

If these situations occur, we will deal with them in detail, and there is no exact preventive measure.

Part of the primary disease of venous cavernous transformation is pancreatic head tumor or bile duct tumor, which usually occurs in the late stage and has a poor prognosis.

The treatment plan is as follows:

It is mainly used to treat portal hypertension, secondary esophageal and gastric variceal bleeding and portal hypertensive gastropathy. Surgery is the main treatment, and drug treatment only plays an auxiliary role.

medicine

The application of drugs to reduce portal vein pressure can reduce the resistance of portal vein system and its collateral circulation, contract visceral vessels, reduce the blood flow and pressure of portal vein and its collateral, and reduce the blood flow at the bleeding place to achieve hemostasis effect, and the hemostasis rate is about 60%. The commonly used drug is pituitrin, 0.4μg/min intravenous drip. 14 peptide somatostatin, the first dose of 250μg intravenous injection, followed by continuous intravenous drip at 250 μ g/h. 8 peptide analogue (octreotide), the first dose 100μg intravenous injection, followed by continuous intravenous drip at 250μ g/h.

Interventional radiotherapy

Selective abdominal arteriography, after determining the location and cause of bleeding, can effectively control bleeding through catheter drug perfusion or embolization.

Endoscopic therapy

Endoscopic injection of sclerosing agent or ligation of esophageal varices, and intravenous injection of tissue adhesive at gastric varices to embolize blood vessels when necessary, in order to achieve the purpose of hemostasis. Literature reports that the effective rate is 80% ~ 96%, and the rebleeding rate is 12% ~ 28%. However, this method will cause esophageal perforation and stenosis, and occasionally cause thrombosis of other veins (splenic vein, superior mesenteric vein, etc.). ).

Surgical therapy

Patients with good liver function and hypersplenism should be treated by surgery.