Presentation
Abdominal pain and general weakness.
Patient Data
The portal vein with its right and left main branches are distended with luminal thrombosis.
The splenic vein is completely thrombosed, and the spleen is enlarged showing multiple wedge-shaped non-enhanced areas representing splenic infarcts.
The superior mesenteric vein is thrombosed.
Case Discussion
Portal venous thrombosis (PVT) is a major cause of non-cirrhotic portal hypertension.
Portal vein thrombosis and portal venous system thrombosis can occur due to many causes: Liver cirrhosis, neoplastic disease, inflammatory/infectious intra-abdominal processes, hypercoagulable states, and some anatomic variants.
CT is commonly used to diagnose acute PVT and assess for possible causes and complications, such as bowel ischemia, the septic source, and associated malignancy, in addition to determining the extent of thrombosis and mapping the portosystemic collaterals for possible intervention.
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