Aa
Aa
A
A
A
Close
220090 tn?1379167187

Hepatic Vein Thrombosis

I went to Mt Sinai for my yearly checkup and fibroscan.  The scan improved once again, but not so dramatically.
I have been going for an ultrasound to screen for HCC every 6 months, but this time, my doctor said I should have an MRI once a year and an ultrasound once a year.  There is lots of experience with SVR people and HCC rates following SVR and he felt this would provide better detection of any carcinoma.

The good news was that no cancer was detected.  The bad news is that I have blockage in the right hepatic vein, probably from a thrombosis.  I have no symptoms from this as the other veins are patent.  

So back to regular doctor visits and now an MRV monday morning.
33 Responses
Sort by: Helpful Oldest Newest
220090 tn?1379167187
By the way, Medicare denied payment for the MRV and the hospital tried to get me to pay $2,900 for it.  I appealed and supplied them with letters from Dr D and policies from Aetna that does pay for  Budd-Chiari syndrome.

I won the appeal and medicare paid the hospital $360 and the hospital accepted the payment.  Go figure, they wanted me to pay 9 times that, but were happy to accept Medicare's payment.
Helpful - 0
220090 tn?1379167187
I never had to take blood thinners, so I am lucky.    Scared me though and made me feel lucky to have it resolved.  

I don't get on medhelp much any longer since I don't know most people on the forum these days.  I hope you are doing well and enjoying life.

Eric
Helpful - 0
223152 tn?1346978371
Never caught this thread in September so it is nice to read now that after 6 months everything is back to normal.  I assume that was with no medicine/blood thinners.  I have always thought of you as an extremely fit person so was surprised at this thread.  I am glad it is resolved.
bean
Helpful - 0
4670047 tn?1375730401
That's wonderful news!!! Less worry, more boating! Lol!
Helpful - 0
220090 tn?1379167187
Just a follow up.  I had a doppler scan of my liver to test blood flow and everything has returned to normal.  All is well.
Helpful - 0
220090 tn?1379167187
Went to see a hepatologist at Tampa Hospital.  He is associated with the transplant center there.  He showed the pictures to a transplant surgeon and their opinion is to just watch it.  They don't believe it will progress or cause me any symptoms.

I wish I didn't know about it, but at least I don't have to take a blood thinner.
Helpful - 0
1815939 tn?1377991799
Wishing you the best in whichever treatment you have.
Helpful - 0
220090 tn?1379167187
I missed your question back some posts.  They are going to send me to a hematologist to get treated for the clot.  There are drugs to prevent clotting and some that bust clots.  I don't know what they will do.  Hopefully, I will see the hematologist next week and get some answers.  The vein is not completely blocked and I have no symptoms.

In general, there is enough HCC in people that SVR to cause most docs to get more aggressive with ultrasound and MRI testing for HCC regardless of the stage, unless it is 1 or less.
Helpful - 0
Avatar universal
I wish you a complete and speedy recovery Eric.
Be well,
Mike
Helpful - 0
220090 tn?1379167187
I have made an appointment with a Dr at  Tampa General.  This practice is associated with the transplant center, so they are well versed in liver architecture.

Dr D says this is not serious now, but would become serious if it spreads to the other two hepatic veins.  I am puzzled about why it happened, but I might never know that.  The clot is stable in size for the 3 months between MRIs, so that's good news.

It's great to see some of my old friends still here helping people.  I hope you are all well.  Meanwhile, I am still enjoying life and planning to continue that for many more years.

Eric
Helpful - 0
683664 tn?1330966324
What a surprise, so sorry to hear that you are having to deal with this.  Thank you for sharing this information, it is educational for all of us.  I will be watching to hear your progress as more information comes in.  Best wishes.

Lapis
Helpful - 0
412873 tn?1329174455
Gosh, Eric-so sorry to read this.  Have you decided on a course of treatment?  After all you've gone through for liver health, then this comes out of left field.  I'm wishing you (and the lovely Mrs) all good outcomes.  

And if I'm reading correctly, Willy's in a trial?  Never thought I'd see the day, lol!  Hope all is going well for ya, Willy

Isobella
Helpful - 0
220090 tn?1379167187
Got the MRV result today.  It shows a 7cm thrombosis in the middle hepatic vein.  Left and right hepatic veins and all portal veins have normal flow.  The middle vein is not completely obstructed and I have no symptoms.
Helpful - 0
220090 tn?1379167187
Thanks for all the support.  You are all the greatest!
Helpful - 0
220090 tn?1379167187
Great to hear from you.  

I feel great, so I doubt this is anything serious.  I will no for sure in a few days when the radiologist looks at the pictures and writes a report.

I am hoping that Medicare will pay for the MRV.  The lab that took the pictures here in Sarasota says it won't, but Mt Sinai says it will.  I did lots of searches on the web and found sites (not Medicare itself) that say it will pay for an MRV when a thrombosis of the hepatic veins is suspected.

I hope all is well with you.  Sounds like it is.

Eric
Helpful - 0
Avatar universal
Good to see you are still going mostly strong and have a decent prognosis.

I had a surprise this year..... I was getting an EKG and the tech kept throwing away each EKG printout.

They ran a few, through em away, ran some more.....
the tech finally came back w/ 2 nurses.....and they ran a few , repositioned the leads and tried again, threw em away...

Finally I said; "Whats going on?"

The nurse said; "This says you're having a heart attack.  Are you?"
: )

I said I am now.........  : )

It turned out that I had an irregular heart beat.
I was screening for a trial and I thought; well, that's then end of that.  : (

Later on in the screening when I asked to see the prohibited list of herbs, drugs, etc, and I figured out that the tonic water I had been drinking for leg cramps (contains quinine) was similar enough to a prohibited quinilone drug (which caused heart arrhythia).

I quit the quinine/tonic water that day and have had numerous EKG's in the trial; all normal.

I wish yours was that easy.

Wishing you the best Eric, and all my old buddies....

Willy
Helpful - 0
446474 tn?1446347682
"Ten year prognosis for one blocked vein is 95%."
Great! That is excellent news.
(10 years sounds like an eternity to me. haha)

Hopefully you don't even have one blocked.

Keep that blood flowing!
Keeping my fingers crossed for you.
Howie
Helpful - 0
Avatar universal
Sounds like good news Eric. I'm sure them Techs are quite used to looking at those........ Though I don't understand at age 5 what makes you think 10 years is good....... :)

Wishing you the best........
Helpful - 0
220090 tn?1379167187
I went for an MRV of the liver today.  I asked the technician if he could see the blockage and he said no.  I will have to wait for the radiologist to look at the pics and right a report before I have a definitive answer, but I am encouraged that the technician couldn't see anything.

The MRV is the definitive test for this syndrome. Ten year prognosis for one blocked vein is 95%.  Given my age, my 10 year prognosis with no problems is less than that - LOL.
Helpful - 0
446474 tn?1446347682
This is the definition I found at "UptoDate" a database of articles for physicans. I don't have a prescription but you can get access to the intro.

Etiology of the Budd-Chiari syndrome

Introduction

..."Thus, the Budd-Chiari syndrome is due to occlusion or partial occlusion of one, two, or all three of the major hepatic veins (right, middle, and left) and/or occlusion or partial occlusion of the inferior vein cava (figure 1) [6]. In addition, several small veins that enter the inferior vena cava directly from the posterior surface of the caudate lobe and occasionally from the right and left hepatic lobes may or may not be involved by the occlusive process."

There are 64 links to documents about Budd-Chiari syndrome here...
http://www.uptodate.com/contents/etiology-of-the-budd-chiari-syndrome

Here are some other links...
http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/583/viewFullReport

http://www.biomedcentral.com/1471-230X/10/25

I am glad it is only one vein although that sounds frightening enough. Hoping for simple effective treatment.

I will be following your progress.
Be well.

Howie
Helpful - 0
220090 tn?1379167187
I believe Budd–Chiari syndrome occurs when all 3 hepatic veins are blocked and only one of mine is blocked at this point.

Thanks for the support Howie.  I check the forum regularly to see how you are doing.

Eric
Helpful - 0
446474 tn?1446347682
You are right. Your situation seems good as far as thrombosis is concerned. I hope they can get a handle on it while it is still mild.

Have they concluded this is Budd–Chiari syndrome?

Causes
* The cause cannot be found in about half of the patients
* Primary (75%): thrombosis of the hepatic vein
* Secondary (25%): compression of the hepatic vein by an outside structure (e.g. a tumor)
* Hepatic vein thrombosis is associated with the following in decreasing order of frequency:
a) Polycythemia vera
b) pregnancy
c) post partum state
d) use of oral contraceptive
e) paroxysmal nocturnal hemoglobinuria
f) Hepatocellular carcinoma
g) Lupus anticoagulant
* Infection such as tuberculosis
* Congenital venous webs
* Occasionally inferior vena caval stenosis

The hepatic veins comprise of three large veins which are the right hepatic vein, the middle hepatic vein and the left hepatic vein drain the hepatic parenchyma into the IVC. There are separate small veins draining the caudate lobe of the liver.

* Right hepatic vein
The right hepatic vein runs at the right hepatic fissure and drains segments V, VI, VII and VIII. The plane of the right hepatic vein separates the segments VI and VII (which are posterior to this plane) and segments VIII and V (which are located anterior to this plane).

Variants
It is a single dominant vein in 60 - 78% individuals. There may be early bifurcation (splitting into 2 parts), early trifurcation (splitting into 3 parts)or even multiple right hepatic veins entering the IVC (inferior vena cava). This may make it difficult to deduce segmental anatomy of the liver.

Here is a good diagram of typical liver venus architecture.
http://livertransplantadvice.com/img/fig1.3_std.jpg


Hang in their buddy.
This is just a temporary bump in the road.
Howie
Helpful - 0
220090 tn?1379167187
The good news is that the portal veins are patent as is the left hepatic vein.  No portal hypertension is visible in the scan, so I am puzzled about why the clot formed.  I will know more when I get the results of the MRV and talk to the docs.
Helpful - 0
220090 tn?1379167187
Birth control pills caused it in some women during the late 60s.  I don't think the newer ones used today can cause it, but I am not sure.  I read lots of articles about it on the net, but none listed definitive causes.
Helpful - 0
2
Have an Answer?

You are reading content posted in the Hepatitis C Community

Top Hepatitis Answerers
317787 tn?1473358451
DC
683231 tn?1467323017
Auburn, WA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Answer a few simple questions about your Hep C treatment journey.

Those who qualify may receive up to $100 for their time.
Explore More In Our Hep C Learning Center
image description
Learn about this treatable virus.
image description
Getting tested for this viral infection.
image description
3 key steps to getting on treatment.
image description
4 steps to getting on therapy.
image description
What you need to know about Hep C drugs.
image description
How the drugs might affect you.
image description
These tips may up your chances of a cure.
Popular Resources
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.