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Portal Vein Thrombosis
Portal vein thrombosis is a blood clot in the main vein carrying blood from the intestines to the liver, risking liver complications. At GastroDoxs in Houston, Dr. Nghia Nguyen delivers expert diagnosis, personalized treatment and support to restore hepatic health.
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Common Causes and Risk Factors
Cirrhosis and other chronic liver diseases
Intra-abdominal infections or inflammation (e.g., pancreatitis, appendicitis)
Abdominal or pelvic malignancies
Inherited or acquired hypercoagulable states
Recent abdominal surgery or trauma
Hormone therapy or oral contraceptive use
Inflammatory bowel disease
Signs and Symptoms
Often asymptomatic in early stages
Upper right-quadrant abdominal pain or discomfort
Abdominal swelling or bloating (ascites)
Nausea and vomiting
Feeling of fullness in the left upper quadrant (enlarged spleen)
Gastrointestinal bleeding (vomiting blood or passing black, tarry stool)
Unexplained fatigue or weakness
How Dr. Nghia Nguyen Diagnoses Portal Vein Thrombosis with Epigastric Pain
Dr. Nguyen uses a step-by-step approach:
Medical History and Physical Exam
He reviews your symptoms, focusing on the onset and character of epigastric pain, abdominal surgeries or injuries, liver disease history, hormone use, and clotting risk factors. A targeted abdominal exam checks for tenderness, swelling, ascites, or splenomegaly.
Blood Tests
Laboratory studies include liver function tests (AST, ALT, bilirubin), complete blood count (platelet count), and a coagulation panel (PT/INR, aPTT). When indicated, specialized tests for thrombophilia or inflammatory markers are ordered.
Imaging Studies
Abdominal ultrasound with Doppler - the first-line test to visualize the portal vein, assess blood flow, and detect a thrombus.
Contrast-enhanced CT scan or MRI - provides detailed anatomy of the portal system, defines clot extent, and evaluates collateral circulation.
Advanced Testing (if needed)
In select patients, endoscopic ultrasound or digital subtraction angiography may be used to further characterize the thrombus, guide therapeutic interventions (such as catheter-directed thrombolysis), or assess portal hemodynamics.
Treatment
Our Team offers a full range of care for portal vein thrombosis.
1. Diet and Lifestyle Changes
Following a low-sodium diet to control swelling
Eating balanced meals with fruits, vegetables, and lean protein
Staying active with light exercise to improve circulation
Avoiding alcohol to reduce strain on the liver
2. Medications
Blood thinners to dissolve clots and prevent new ones from forming
Diuretics to manage fluid retention (ascites)
Pain relievers for abdominal discomfort when needed
3. Advanced Procedures
Thrombolysis via catheter to deliver clot-dissolving medication
Transjugular Intrahepatic Portosystemic Shunt (TIPS) to create new blood-flow pathways
Endoscopic treatments to control bleeding from enlarged veins in the esophagus or stomach
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Frequently Asked Questions
What causes portal vein thrombosis?
Portal vein thrombosis occurs when a blood clot forms in the portal vein. Common risk factors include liver disease (cirrhosis), abdominal infections or inflammation, cancer, clotting disorders, surgery or injury, and certain hormone therapies or birth control pills.
What symptoms should I watch for?
Symptoms range from mild to severe and may include upper right abdominal pain, abdominal swelling (ascites), nausea or vomiting, a feeling of fullness near the spleen, and signs of gastrointestinal bleeding such as vomiting blood or passing tarry stools.
How is portal vein thrombosis diagnosed?
Diagnosis starts with a review of your medical history and a physical exam. Blood tests check liver function and clotting factors, and imaging studies—typically ultrasound, CT, or MRI—confirm the presence and extent of the clot.
What treatment options are available?
Initial treatment often involves anticoagulant (blood-thinning) medications to dissolve the clot and prevent new ones. Additional therapies may include diuretics for fluid buildup, catheter-directed thrombolysis, TIPS (transjugular intrahepatic portosystemic shunt), or endoscopic procedures to manage bleeding.
Can portal vein thrombosis resolve on its own?
Small clots can sometimes resolve with medical therapy, but untreated clots may lead to serious complications. Early evaluation and treatment by a specialist are essential for the best outcome.
Will I need long-term medication?
Some patients require anticoagulation for several months or indefinitely, depending on the underlying cause and risk of recurrence. Your gastroenterologist will tailor the duration of therapy to your individual needs.
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