Tratamiento de la Trombosis Aguda de la Vena Porta en TVP Reciente Sin Cirrosis Subyacente
Escenario Clínico
Este protocolo se aplica a pacientes con trombosis reciente de la vena porta en ausencia de cirrosis. El reconocimiento temprano y la intervención precoz son esenciales para proteger la viabilidad intestinal y restablecer el flujo venoso portal adecuado.
Enfoque Terapéutico
La piedra angular del manejo en este contexto es la terapia anticoagulante. Los agentes específicos, la secuenciación y la duración se definen en el protocolo completo — el régimen completo no se resume aquí.
Objetivos Clínicos
- Recanalización de la vena porta
- Ausencia de isquemia intestinal (sin necrosis intestinal)
References
DOI: 10.1016/j.jhep.2025.08.001
- Anticoagulation initiated as soon as possible is the first-line therapy for recent PVT in the absence of cirrhosis.
- Anticoagulation should be initiated as soon as possible, since early initiation of anticoagulation may reduce the risk of developing intestinal ischaemia and increases the probability of portal vein recanalisation.
- Anticoagulation should be continued for at least 6 months.
- Anticoagulation initiated as soon as possible is the treatment of choice.
- In patients with recent PVT without cirrhosis, direct oral anticoagulants are suggested as an alternative to low-molecular-weight heparin and/or vitamin K antagonists, during the first 6 months after PVT diagnosis, to reduce morbidity and mortality.
- In patients with recent PVT, there are two main goals of anticoagulant treatment: (i) to prevent bowel necrosis requiring bowel resection and (ii) to achieve sufficient recanalisation of the portal venous system to prevent the future development of portal hypertension and its complications.
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