Thrombosis.

Etiology.—Thrombosis of the portal vein is quite rare, and may be preceded by syphilis of the liver, cirrhosis, cancer, pressure by tumors, perforation of the vein by gall-stones, and peritonitis, where the gastro-hepatic is involved.

Pathology.—The clot which at first is of a yellowish-gray color, may suppurate, or it may become organized into connective tissue, the vein becoming like a fibrous cord, and is known as adhesive pylephlebitis adhesiva. Occasionally the clot becomes channeled, the circulation becomes re-established, and a cure may result.

Symptoms.—Unless the occlusion be complete, the symptoms are negative, or may resemble those of cirrhosis. Where there is complete obstruction, ascites rapidly develops, there is swelling of the spleen, and hemorrhage from the nose, stomach, and bowels.

Diagnosis.—This is extremely difficult, and often only made positive during an autopsy. Perhaps the most suggestive symptom is rapid engorgement of the portal system, and quick development of ascites.

Prognosis.—This is always grave, although some recover.

Treatment.—This is not very satisfactory, and usually only gives temporary relief. It is entirely symptomatic, meeting the conditions as they arise. Fluids should be used sparingly, and when ascites is marked, paracentesis should be performed. The diet should largely consist of fruits and vegetables.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.