[When should vascular liver disease be considered?]

Area of Science:

• Hepatology
• Vascular Medicine
• Diagnostic Radiology

Background:

• Vascular liver diseases (VLD) are uncommon and frequently diagnosed late, delaying essential treatment.
• Diagnosis often requires a multidisciplinary approach involving clinicians, radiologists, and pathologists.
• Unexplained abnormal liver tests or portal hypertension without cirrhosis are key indicators of porto-sinusoidal vascular disease.

Purpose of the Study:

• To highlight the diagnostic challenges and multidisciplinary nature of vascular liver diseases.
• To emphasize the importance of early detection for timely intervention.
• To discuss clinical presentations that should raise suspicion for VLD.

Main Methods:

• Review of diagnostic pathways for VLD.
• Emphasis on multidisciplinary team collaboration (clinician, radiologist, pathologist).
• Identification of key clinical signs and patient contexts suggestive of VLD.

Main Results:

• VLD diagnosis is often delayed due to non-specific symptoms and rarity.
• Acute splanchnic thrombosis presents with abdominal pain; Budd-Chiari syndrome mimics other liver diseases.
• Multidisciplinary dialogue is essential for identifying VLD, distinguishing it from common liver conditions.

Conclusions:

• Early diagnosis of VLD is critical for optimal patient management.
• Suspicion of VLD should arise in specific clinical scenarios, prompting further investigation.
• Timely diagnosis facilitates treatments like anticoagulation and management of portal hypertension.