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Case report
Management of acute extensive portal vein thrombosis: the complexity and morbidity
  1. Andy Ze Lin Chen1,
  2. Matthew George Roy Allaway1,
  3. Rafid Al-Asady2 and
  4. Arthur Richardson1
  1. 1Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Department of Radiology, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Dr Andy Ze Lin Chen; andy.chen{at}


A 62-year-old patient was admitted with an acute unprovoked portal vein thrombosis with splenic and mesenteric extension. His progress was complicated by progressive small bowel ischaemia and increasing clot burden despite systemic anticoagulation. This case report describes the use of catheter-directed thrombolysis via a transjugular intrahepatic portosystemic shunt, with the disease and its treatment complicated by a ruptured iatrogenic pseudoaneurysm, abdominal compartment syndrome and small bowel infarction necessitating extensive small bowel resection.

  • portal vein
  • interventional radiology
  • gastrointestinal surgery

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  • Contributors AZLC conducted the literature search and wrote the case report. AR managed the patient. MGRA, RA-A and AR offered support and edited the final article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.