الفهرس 
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Abstract
PVT is a relatively common complication of cirrhosis, however its effect on the prognosis of cirrhosis is equivocal. PVT is being diagnosed more frequently due to the increasing use of advanced sonography, computed tomography (CT), and magnetic resonance imaging techniques. However, PVT may be asymptomatic but may present also with clinical symptoms and can progress to life-threatening complications of ischemic hepatitis, liver failure, and/or small intestinal infarction. The aim of the present study was to assess the clinical, sonographic and endoscopic findings in Egyptian patients with liver cirrhosis suffering from portal vein thrombosis in comparison with patients without portal vein thrombosis and to look for predictors for development of portal vein thrombosis in such patients. The study included 75 patients, suffering from chronic liver disease and were divided into the following 2 groups having liver cirrhosis with and without portal vein thrombosis. The study patients were recruited from outpatient clinics and inpatient gastroenterology and hepatology Unit at the Specialized Medical Hospital of Mansoura University. Study patients were subjected to the following:- Full history taking with emphasis on age, gender, occupation, life style, medications used including anti-viral or anti-bilharzial, beta-blockers or others, history of GIT bleeding and variceal ligation or sclerotherapy, history of thrombosis and family history.- Clinical examination:- Blood pressure (supine and upright): - Pulse: Manual palpation for rate, rhythm and special character of the pulse- Complexion with stress on jaundice and pallor- Weight and height and BMI calculation and signs of malnutrition - General signs of liver cell failure including palmar erythema, spider naevi, flapping tremors…etc.- Oedema of lower limbs and its degree- Abdominal examination:• Liver palpation, spleen, ascites, venous hum, dilated veins, tenderness in cases of spontaneous bacterial peritonitis- Chest and heart examination3-Investigations:A: Laboratory investigations:- Complete blood count (CBC).- Blood urea nitrogen, serum creatinine, liver function tests.- Coagulation profile - Alpha fetoprotein (AFP)- Hepatitis Viral markers Scoring system of the severity of liver disease: Modified child-Pugh score (CPT score): B. Abdominal ultrasonography and Doppler examination of hepatic, splenic and mesenteric vessels. C. Upper gastro-intestinal endoscopy to assess esophageal and gastric varices , portal hypertensive gastritis (PHG) , erosive reflux disease and gastritis. esophageal varices were assessed according to the Japanese Research Society for Portal Hypertension. The following results were obtained:- The study included 77 subjects of whom 27 had portal vein thrombosis which affected the main branch in most cases (25/27, 92.5%) while two patients have thrombosis of either right or left branch.- Comparison of clinical characteristics between cirrhotic patients with and without PVT showed statistically significantly higher proportions of positive history of hepatic encephalopathy, surgically removed spleen and mild to moderate ascites by percussion in PVT vs. non-PVT patients.- Comparisons of radiological findings between cirrhotic patients with and without PVT showed statistically significantly higher proportions of surgically removed or huge spleen by US, mild to marked ascites by US, hepatic focal lesion or diffuse HCC suspicion by US or confirmed cases by Triphasic CT in PVT vs. non-PVT patients.- Comparisons of CTP score between cirrhotic patients with and without PVT showed significantly higher proportions of class ‘C’ cases on Child Turcotte Pugh score in PVT vs. non-PVT patients.- Comparisons of endoscopic findings between cirrhotic patients with and without PVT revealed a statistically significantly higher proportions of huge varices F3 in PVT vs. non-PVT patients.