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Idiopathic portal vein thrombosis not related to hepatic disease or malignancy
  1. Samer Alkassis1,
  2. Nathan Zaher1,
  3. Zaid Kaloti1 and
  4. Diane Levine2
  1. 1Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA
  2. 2Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
  1. Correspondence to Dr Samer Alkassis; salkassi{at}med.wayne.edu

Abstract

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.

  • haematology (incl blood transfusion)
  • venous thromboembolism
  • cirrhosis
  • portal vein

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Footnotes

  • Contributors DL, ZK, NZ and SA contributed to report preparation. SA took the lead in writing the case report. All authors provided critical feedback and helped shape the case.

  • 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.

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

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