Idiopathic portal vein thrombosis not related to hepatic disease or malignancy.
Samer AlkassisNathan ZaherZaid KalotiDiane LevinePublished in: BMJ case reports (2021)
Acute portal vein thrombosis (PVT) is a rare disorder defined by the sudden occlusion of the portal vein, which could be partial or complete. Prothrombotic states, inherited or acquired, are thought to be the cause in patients without cirrhosis or malignancy. However, the aetiology of some cases remains idiopathic despite a multidisciplinary diagnostic approach. The initial diagnostic modality to confirm PVT is either contrast-enhanced abdominal (CT) or MRI; as it can identify predisposing factors, and detect evidence of complications. Eliciting the underlying aetiology is critical to guide overall management and prevent future recurrence. The purpose of treatment is to stop thrombus extension and achieve portal vein patency by anticoagulation to optimise outcomes. Herein, we present an unusual case of spontaneous PVT in a young woman. We will also discuss the evaluation of patients without obvious aetiology.
Keyphrases
- contrast enhanced
- end stage renal disease
- magnetic resonance imaging
- newly diagnosed
- ejection fraction
- computed tomography
- chronic kidney disease
- diffusion weighted
- pulmonary embolism
- magnetic resonance
- metabolic syndrome
- prognostic factors
- atrial fibrillation
- intensive care unit
- positron emission tomography
- patient reported outcomes
- liver failure
- weight loss
- middle aged
- extracorporeal membrane oxygenation