Portal Venous Thrombosis in Alcoholic Hepatitis: A Relatively Unknown Association.
Shanmukhaswetha PerabattulaSameera QuraishiAsim KichlooDushyant Singh DahiyaPublished in: Journal of investigative medicine high impact case reports (2023)
Portal venous thrombosis (PVT) is a rare diagnosis in the general population. However, it is seen in patients with liver cirrhosis with an estimated prevalence ranging from 0.6% to 26%. Literature reports that about one-third of PVT cases have an unknown etiology. Identifying the precipitating factors implicated in the development of PVT is imperative as it may help guide therapy. Although the association between liver cirrhosis and PVT has been well established in current literature, there continues to be a relative lack of awareness of alcoholic hepatitis (AH) as a risk factor for PVT. Identifying AH as a trigger for thrombosis can help avoid extended anticoagulation and its complications. In the following case report and brief review, we discuss an uncommon case of a 33-year-old male who came to the hospital emergency department with complaints of nauseousness, abdominal discomfort, and yellow discoloration. Lab investigations showed transaminitis. The diagnosis of AH was established, and an abdominal duplex ultrasound revealed PVT. Heparin drip was started as a part of treatment, which improved his abdominal discomfort. He was eventually discharged on apixaban 5 mg twice daily for 3 months and a repeat abdominal duplex ultrasound in 3 months to check for the resolution of the PVT.
Keyphrases
- emergency department
- venous thromboembolism
- systematic review
- magnetic resonance imaging
- atrial fibrillation
- risk factors
- healthcare
- liver injury
- pulmonary embolism
- physical activity
- ultrasound guided
- mesenchymal stem cells
- computed tomography
- single molecule
- stem cells
- bone marrow
- drug induced
- growth factor
- replacement therapy
- smoking cessation