Hepatic venous outflow block caused by short-length hepatic vein stenoses.

Abstract

In contrast with the well-recognized membranous obstruction of the inferior vena cava, short-length hepatic vein stenoses are not well-recognized causes of hepatic venous outflow block. The aim of this study was to ascertain the prevalence, causes, manifestations, and outcome of short-length hepatic vein stenoses. We performed a retrospective study of patients with short-length hepatic vein stenosis among 86 patients with hepatic venous outflow block who were seen between 1970 and 1992. There were 25 patients with short-length hepatic vein stenosis. A thrombogenic condition was identified in 14 patients (56%). The lesions of the accompanying hepatic veins in these patients were variable (short-length stenoses, thromboses, or nonspecific changes) and similar to that seen in patients without short-length hepatic vein stenosis. In 3 necropsied cases, the venous lesions were suggestive of fibrous sequela of prior thromboses. In patients with short-length hepatic vein stenosis, splenomegaly (28% vs. 55%, P < .05) and hypersplenism were significantly less common; serum transaminase (P < .001) and creatinine levels (P < .02) were lower, prothrombin was higher (P < .001), and 5-year survival was significantly better (Kaplan-Meier estimates: 80% vs. 50%, P < .05). In patients with hepatic venous outflow block, short-length hepatic vein stenosis is a common lesion that appears to be the sequela of localized thrombosis. Long-term anticoagulation and percutaneous angioplasty (with or without stenting) are potentially applicable in these lesions. The long-term results of these treatments merit further evaluation.

• Authors: D Valla, A Hadengue, M el Younsi, N Azar, G Zeitoun, M J Boudet, G Molas, J Belghiti, S Erlinger, J M Hay, J P Benhamou
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 25 Issue 4 Pg. 814-9 (Apr 1997) ISSN: 0270-9139 [Print] United States
• PMID: 9096581 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Budd-Chiari Syndrome (complications, etiology, pathology, physiopathology)
• Constriction, Pathologic
• Female
• Hepatic Veins (pathology, physiopathology)
• Humans
• Male
• Middle Aged
• Vena Cava, Inferior (pathology, physiopathology)