title: [Natural history of portal cavernoma without liver disease. A single centre retrospective study of 32 cases].
abstract: OBJECTIVE
  Portal cavernoma follows a chronic occlusion of the portal vein. The long-term consequences of portal cavernoma are not well known. The objective of this study was to report the aetiology of the portal cavernoma and its natural course after excluding liver diseases causes.
  
  
  METHODS
  A single centre retrospective study based on the data collected from the radiology department of the Clermont-Ferrand hospital was conducted from 2000 to 2011. All the patients for whom an imagery found a portal cavernoma have been looked for excluding the patients having a liver disease whatever the aetiology and the Budd-Chiari syndrome.
  
  
  RESULTS
  Thirty-two cases (18 women and 14 men) were selected. The mean age at diagnosis was 54.2 years and the mean follow-up period was 5.4 years. The discovery of a portal cavernoma was incidental for 8 cases. An aetiology was found for 24 cases: it was an haematological aetiology in 15 cases (10 myeloproliferative syndromes, 2 antiphospholid syndromes, 1 thalassemia major, 1 hyperhomocysteinemia, 1 prothrombin gene mutation), a general aetiology in 2 cases (1 coeliac disease, 1 pancreatic neoplasia), and a local inflammation in 7 cases. A dysmorphic aspect of the liver was noticed on medical imaging for 11 out of the 32 cases. A liver biopsy was performed in 4 patients and was normal for all of them. Sixteen patients developed oesophageal varices, 4 patients developed ascites, 3 developed asymptomatic biliary compression by the portal cavernoma, and the patient who had been followed for the longest time (15 years) developed an encephalopathy.
  
  
  CONCLUSIONS
  In addition to its underlying etiology, the prognosis of portal is mainly related to the occurrence of oesophageal varices that may develop during the follow-up of the patients.
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Resseguier
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France; Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Inserm, U1071, M2iSH, 63001 Clermont-Ferrand, France. Electronic address: mandre@chu-clermontferrand.fr.
authors.forename: M
authors.initials: M
authors.lastname: André
authors.affiliation: Service de radiologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France.
authors.forename: E A
authors.initials: EA
authors.lastname: Orian Lazar
authors.affiliation: Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Inserm, U1071, M2iSH, 63001 Clermont-Ferrand, France; Service de gastroentérologie, hôpital Estaing, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Bommelaer
authors.affiliation: Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Service d'hématologie, hôpital Estaing, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: O
authors.initials: O
authors.lastname: Tournilhac
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: I
authors.initials: I
authors.lastname: Delèvaux
authors.affiliation: Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Service de médecine interne, hôpital Estaing, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Ruivard
authors.affiliation: Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Service de dermatologie, hôpital Estaing, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: D'Incan
authors.affiliation: Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Service de radiologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Boyer
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France; Faculté de médecine, université d'Auvergne, 63001 Clermont-Ferrand, France; Inserm, U1071, M2iSH, 63001 Clermont-Ferrand, France.
authors.forename: O
authors.initials: O
authors.lastname: Aumaître
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006392:Hemangioma, Cavernous / Q000473:pathology*; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology*; D008099:Liver / Q000098:blood supply / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000473:pathology; D011169:Portal Vein / Q000002:abnormalities* / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anticoagulants; Cavernome portal; Hypertension portale; Portal cavernoma; Portal hypertension; Portal vein; Thrombophilia; Thrombophilie