Portal vein thrombosis as a rare cause of abdominal pain: When to consider?

Özet

Extrahepatic portal vein thrombosis (PVT) is a rare condition that is characterized by the presence of thrombuswithin any segment of the portal vein, including the right and left intrahepatic branches. It may also extend to thesplenic or superior mesenteric veins. Portal vein thrombosis may be related to cirrhosis or liver malignancy as wellas to local inflammatory conditions in the abdomen and genetic or acquired thrombophilic diseases. Currently,PVT is being increasingly diagnosed due to advances in modern imaging techniques. The clinical presentation has awide range, from an asymptomatic lesion to a potentially life-threatening situation. In this study, we present threepatients with PVT. The diagnosis was made by radiologic and clinical findings. In the first patient, genetic testingrevealed factor V Leiden mutation as the cause of PVT. The second patient was diagnosed with lupus anticoagulantsyndrome as the cause of PVT. Portal vein thrombosis was associated with intra abdominal infection due to anastomotic leakage in the third patient. Two patients were successfully treated with anticoagulant therapy. This reportemphasizes that even though PVT is a rare cause of abdominal pain, timely diagnosis and appropriate managementis vital due to its lethal complications such as mesenteric ischemia and mesenteric infarct.