Portal vein thrombosis

Background

Inciting Causes

• Abdominal sepsis
• Abdominal surgery
• Behçet's syndrome
• Cirrhosis
• Collagen vascular diseases (eg, lupus)
• Compression or invasion of the portal vein by tumor (eg, pancreatic cancer)
• Endoscopic sclerotherapy
• Hepatocellular carcinoma
• Inflammatory bowel disease
• Inherited thrombophilias
• Myeloproliferative syndromes
• Omphalitis
• Oral contraceptives
• Pancreatic islet cell transplantation
• Pancreatitis
• Paroxysmal nocturnal hemoglobinuria
• Pregnancy
• Retroperitoneal fibrosis
• Transjugular intrahepatic portosystemic shunt
• Trauma

Clinical Features

Acute

• Abdominal pain developing suddenly or progressing over a few days
• May be clinically silent in a portion of patients and diagnosed during a CT exam for other reasons (e.g. acute pancreatitis)

Evaluation

• Typically diagnosed on abdominal CT with contrast