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Portal Vein Thrombosis Case Study

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This case study examines the development of Portal Vein Thrombosis (“PVT”) in two patients, M.W. and R.C., diagnosed with adenocarcinoma of the pancreas. In both cases the patients had low volume local disease which responded to treatment over time. Both experienced a longer survival length than typical pancreatic cancer patients, but ultimately experienced thombosis of the portal vein and the superior mesenteric vein. Extrinsic compression of the celiac axis by the tumor further exacerbated the disease. Both patients died as a result of liver failure caused by PVT. New research in this field gives additional insight into prevention, diagnosis, and recognition of this disease. To prevent PVT, low-molecular weight heparin administration reduces …show more content…

Armand Trousseau during a lecture series in Paris3. Since then, further research established the complex and intricate relationship between blood clots and cancer. We know venous thrombosis is the second most common cause of death in patients with cancer, exceeded only by progression of the cancer itself. It is more common than infection, respiratory failure, or bleeding4. In comparison to other cancers, pancreatic cancer has a higher risk of thrombus formation5 and a higher risk of PVT. For example, during a 108 patient study focusing on portal vein thrombosis conducted at the Virginia Mason Medical Center, 30% of patients diagnosed with pancreatic cancer developed PVT6. Clearly, prevention of PVT is a high priority for patients diagnosed with pancreatic …show more content…

PVT is a partial or complete thrombosis within the portal vein or its immediate downstream tributaries. Light symptoms such as fatigue, mild swelling, and abdominal discomfort are the first signs of PVT and are easily overlooked, or attributed to symptoms of cancer or cancer treatment. It can also be nearly asymptomatic until the disease has progressed for a long time. Eventually, symptoms such as ascites, hepatomegaly, and varices present. Varices can rupture and bleed, resulting in potentially life-threatening complications. Additionally, due to a lack of nutrients being delivered to the liver, PVT can cause liver failure. If the disease progresses further, death can result7.
Although the medical community has known about hypercoagulation and its relation to cancer for a century and a half, patients still die as a result of thromboembolism during cancer treatment. PVT specifically is a near silent killer and is not well understood. More research is needed to combat PVT and other forms of venous thromboembolism during

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