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How long do you anticoagulate for cirrhosis patients who have portal vein thrombosis extending to the mesenteric veins?
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2 Answers
Mednet Member
Hematology · University of Alabama at Birmingham
I recommend indefinite anticoagulation for most patients with portal vein thrombosis, and at least 3-6 months if there are risk factors for bleeding. Once they complete anticoagulation for the first 6 months, I re-evaluate their risk of recurrent thrombosis vs bleeding, and if there is an underlying...
How do you manage patients with suspected cholangiocarcinoma that presents with biliary obstruction but has repeated negative brushings/biopsies?
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2 AnswersMednet Member
Medical Oncology · Mayo Clinic, Rochester
This is often encountered in patients with PSC. Patients present with jaundice and biliary stricture, rising CA 19-9, and repeat ERCP with brushing/biopsies have shown no evidence of malignancy (often showed abnormal cells). Brushings have high specificity if positive (99%) but very poor sensitivity...
How do you approach an obese patient on long-term methotrexate with normal liver tests in terms of workup for underlying fatty liver?
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1 AnswersMednet Member
Rheumatology · Mainehealth
Screen with ultrasound.