The liver is a vital organ with multiple and complex functions. “He is the only one to be vascularized by an arterial and venous system,” explains Lucy Meunier, hepato-gastroenterologist at the Montpellier University Hospital Center (CHU). The blood from the digestive system is led by the vein door to be purified, enriched then evacuated by the hepatic veins and redistributed in the organism ”. Each minute, 1.4 liters of blood on average crosses an adult liver.
Blocked liver vessels
Liver vessel disease is characterized by a disturbance of blood flowwhen he arrived in the organ or during his evacuation. “It can be a thrombosis, that is to say the formation of a blood clot at the level of the door vein or one of the three sus-hepatic veins which throw themselves into the vein cellar [qui ramène le sang vers le cœur, NDLR]indicates Doctor Meunier. We are talking in this second case of Budd-Chiari syndrome. »»
The hepatic artery, which supplies the liver in oxygenated blood, is thrombosed more exceptionally, but it can happen in particular After a liver transplant. “You can also find aneurysms (dilation in the form of pockets due to the degradation of the artery wall),” explains the hepatologist. Small vessels that ensure blood microcirculation in the liver can also be reached.
What symptoms for what diagnoses?
These diseases can lead to extreme fatigue, abdominal painascites (liquid present in the abdomen) or even coagulation problems. “The patient can also develop portal hypertension, that is, high pressure in the door vein,” says the hepatologist. But it can also be asymptomatic, which delays the diagnosis.
If in doubt, the doctor prescribes a blood report to check a possible drop in platelets. He can also request a scanner, ultrasound or magnetic resonance imaging (MRI), “but the latter remains useless if it concerns small internal vessels”, explains Lucy Meunier.
Prescribe suitable treatment
In case of thrombosis, the doctor will prescribe anticoagulants to Limit the extension of blood clots. It can also order beta -blockers to reduce portal tension or a diuretic to treat ascites. The caliber of the veins can also be increased thanks to interventional radiology. “The blood sometimes uses derivations to bypass the liver, which can cause varicose veins in the stomach or esophagus and cause, in the long term, a digestive hemorrhage which brings into play the prognosis of the patient”, alerts the specialist. In these situations, radiological or endoscopy intervention can be proposed to avoid complications.
