Jana Badinková, Ľubomír Skladaný, Svetlana Adamcová-Selčanová
Portal hypertensive biliopathy (PHB) is caused by portal vein thrombosis (PVT). It originates due to venous dilation
against the flow of an obstruction, which either presses or narrows bile ducts in its area. PHM manifestations are not
recognisable from those at e.g. primary sclerotising cholangitis (PSC) – cholestasis with consequences and cholangitis
– therefore its presence needs to be considered in each patient with such symptoms and PVT. Portal hypertension is
sometimes possible to be addressed in the treatment - with the help of TIPS, or surgical portocaval shunt – however, in
more advanced stages there is no other choice then to take care of consequences of bile duct stenosis – endoscopically
and with antibiotics. As this treatment does not lead to cholestatic relapse and stabilisation of the condition in each
patient – which emphasis the need for early diagnostics – in some cases there is no other choice than liver transplantation.
This case study shows just such a type of PHB. Patients with PHB require multidisciplinary approach - a surgeon
with experience in the given fields, interventional radiologist, gastroeneterologist with the skills in ERCP, infectologist
and hepatologist.