Thrombosis of renal veins

Description:

Thrombosis of hepatic veins is a disease which is characterized by formation of blood clots in the corresponding vessels in view of what their gleam is blocked in whole or in part.

Symptoms of Thrombosis of hepatic veins:

- ascites (it is found more than in 90% of patients and usually is the main manifestation);
- an abdominal pain (arises at 80% of patients; the hypochondrium is localized in right);
- a gepatosplenomegaliya (the liver and a spleen are increased; meets often);
- jaundice (it is expressed slightly; can be absent)
- hepatic encephalopathy and bleeding from varicose expanded veins of a gullet and a stomach is diagnosed less often (in 10-20% of cases) and observed, as a rule, at patients with far come disease stages.

Reasons of Thrombosis of hepatic veins:

It is possible to allocate the following reasons of development of this pathology:
1. Idiopathic, or primary thrombosis of hepatic veins – pathology which arises as if in itself and is not possible to establish its reasons.

2. Thrombosis of hepatic veins which developed against the background of other morbid conditions:

            - stomach injuries;
            - myeloproliferative diseases;
            - paroxysmal night haemoglobinuria;
            - system lupus erythematosus;
            - disturbances of coagulability of blood;
            - pancreas tumors;
            - tumors of kidneys and adrenal glands;
            - pregnancy and prolonged uncontrollable use of some medicines.

Treatment of Thrombosis of hepatic veins:

Emergency treatment: heparin of 40 000-60 000 PIECES in/in kapelno during 4–6 h, then on 40 000 PIECES/days (from 1st to the 8-10th day) in oil. The dose of drug is selected for a blood clotting time, by tolerances of plasma to heparin and results of a tromboelastografiya.
Maintenance therapy: in 1–3 days before the end of administration of heparin appoint anticoagulants of indirect action (Fenindionum, ethyl бискумацетат, аценокумарол), select a dose individually (decrease in PTI to 40%). For example, Fenindionum doses: in the 1st day — 0,12–0,18 g/days (in 3–4 receptions), in the 2nd day — 0,09–0,06 g/days, in the next days — 0,03–0,06 g/days (depending on PTI).
Contraindications to purpose of anticoagulants: Absolute contraindications: heavy bleeding, recently (within 1 month) the undergone neurosurgical operations, pregnancy, reactions of intolerance.
Relative contraindications: recently postponed heavy bleedings, surgeries (except neurosurgical), a peptic ulcer in the anamnesis or recently had stroke (which is not connected with an embolism).