Portal vein is patent

[wp69]

Hi , just been going through my discharge papers from hospital and noticed the term "Portal vein is patent" , tried to google it but not getting much sense , could anyone advise please what the terminology means , Many thanks , Will

[iojiojio9]

Patent means open, as in not obstructed, so as far as I can tell that's a good thing!

[wp69 in reply to iojiojio9]

Thanks , but do have an enlarged spleen

[iojiojio9 in reply to wp69]

the implication of that as I understand is that you could have portal hypertension (too much pressure in your portal vein), a serious complication that can lead to acities (fluid in abdomen) and varices (holes in the esophagus that can rupture and cause severe bleeding), they will probally do an endoscopy (camera down throat/esophagus) to look for any varices and band them before they can rupture, you may get some medication if the acities develops/TIPPS procedure to help with the hypertension of the portal vein. That said not everyone with splenomegaly (enlarged spleen) has portal hypertension - Good luck to you!

All this is only applicable if you actually have Cirrhosis mind you.

[wp69 in reply to iojiojio9]

I have no acities as was proven bu US and had an endoscopy which showed nil varices , so I suppose that is quite encouraging in some shape or form , cirrhosis was detected on the US , as I was nor in my local hospital , working away , I have been referred back to my health board and have not had a proper consultation yet , thanks.

[iojiojio9 in reply to wp69]

Great! the goal would be to try to maintain this position as long as you can.

[wp69 in reply to iojiojio9]

I was given Childs Pugh score of 9 , but the goal is to get it down to 6 , im still fully functional and appetite is very good , I would imagine its a long road.

[iojiojio9 in reply to wp69]

That sounds like a MELD (or UKELD) score rather than a Child Pugh score (they are A, B and C) but it sounds like you would be Child A (the best) since the child scoring system is based more on symptoms rather than MELD which is bloods.

I also have a MELD of 9/Child A score.

[wp69 in reply to iojiojio9]

Ah , thank you , it must have been a B than hopefully I can lower it to an A , as im still very active like I said , im still a bit in the dark as I only saw the consultant bedside for 5 minutes max before the last CT scan was taken , which explained a lot more than what was mentioned by him to me.

[iojiojio9 in reply to wp69]

The thing is 6 is the lowest a MELD can go so it sounds like you have been given a MELD (UKELD), having a MELD of 9 (still low) doesn't mean you would be Child B, since Acisites is absent, if HE (Hepatic Encephalopathy - mental confusion) is also absent then so long as your bloods are reasonable you will be A and thus have a life expectancy in the highest bracket (google "Child turcotte pugh A life expectancy" it if you would like to know), based on what your saying A sounds the most likely - of course liver transplantation could extend your life significantly beyond this if you ultimately get one.

[wp69 in reply to iojiojio9]

That's brilliant , I think bilirubin was high , that what pushed the score up and some other bloods also

[iojiojio9 in reply to wp69]

Same with me, my bilirubin was 24.

[wp69 in reply to iojiojio9]

Do you think it will stabilise or come down , the bilirubin score

[iojiojio9 in reply to wp69]

If the cause of the cirrhosis is removed (alcohol, bad food, hepatitis virus etc.) then the bilirubin certainly can come down, though not always. The hope is there are enough healthy cells in your liver that can allow it to function for some more time.

[wp69 in reply to iojiojio9]

I was a drinker , and very heavy on the salt and salt rich foods , and now try to eat a diet rich in fruits and veg , I know it sounds silly but I would literally eat salt off my finger

[Hidden in reply to wp69]

perfectly normal to have eaten salt off your finger, it's easy to judge in hindsight, just good to admit your mistakes and accept you did something stupid back then and not do it again, we have all done stupid things 😀

[Mango5cm in reply to iojiojio9]

apology to Wp69 for asking another question to iojiojio9.

You mentioned TIPS and I wondered if you knew anything about the procedure. My son is waiting for an assessment at Newcastle Freeman to see if he is suitable for the procedure . He has 10 litres drained every week . Thank you Carol

[Hidden in reply to Mango5cm]

Hi Carol, have they determined whether the fluid build up is from Ascites or a blockage in the portal vein?

[Mango5cm in reply to Hidden]

it’s Ascites .he’s had a heart scan and that was ok . I’m just so worried about him

[Hidden in reply to Mango5cm]

Sorry, iojiojio9, I feel bad hijacking the end of your post discussing something else, apologies.

Hi Carol, I feel so sad for you worrying about your son and him having to deal with this.

I feel a sense of dejavu here (even though I did not touch alcohol, I lived through the constant drains myself), not sure if you have read my previous posts but pretty much went through this pre-tp. My very limited understanding of TIPS is that it is more relevant to blockage than ascites, but as the heart scan was fine I wouldn't think TIPS is relevant, but I really don't know.

I was tempted by the Rocket as I had to have these drains constantly inserted, horrible experience, yet bitter sweet, temporary relief each time they drain, except the constant loss of muscle, really disheartening, just have to keep pushing yourself to try build muscle back up as much as you can with protein, monitoring Albumin etc. to try and be strong enough for tp. 58 sounds like he should be on tp list?

Has your son been transplant assessed yet?

[AnxiousPete in reply to iojiojio9]

Varices aren't holes unless they rupture. They're enlarged blood vessels like varicose veins but serious if they are grade 3 and rupture.

[Roy1955]

"Portal vein is patent" is good.It means it's not blocked or swollen and bloods flowing normaly.

If your overweight watch the fruits.

Most are high in sugars.

Watermelons about the best.