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Abstract

Introduction & Aim: Portal vein thrombosis (PVT) has become an increasingly recognizable disorder during evaluation of cases of abdominal pain with usage of widespread imaging techniques. PVT can result due to various clinical conditions like chronic liver disease, infections, malignancies and hypercoagulable states. The objective of this study is to observe the clinical presentation and to do the etiological work up of cases of PVT in a tertiary care center. This can aid in early diagnosis and expert intervention thereby reducing the morbidity in cases of PVT. Methods: The study is a cross-sectional observational study done on patients having PVT, who presented to Institute of Medical Gastroenterology, MMC and RGGGH, during the period of Jan 2016-July 2017 were taken up for the study. The clinical presentation of the above patients was observed and their etiological work up done. Results: Totally 45 cases were taken into study. 27 were males and 18 were females. Clinical presentation: The main symptoms were, abdominal distension (18 patients, 51%), abdominal pain (10 patients, 27%), pain associated with diarrhea and vomiting (5 patients, 14%) and pain with nausea and anorexia (3 patients, 8%). Etiological work up showed chronic liver disease (24 patients, 54%), prothrombotic states (9 patients, 20%) local factors, prothrombotic risks and idiopathic causes (12 patients, 26%). Detection of PVT were done mostly by Portal vein Doppler (32 patients, 72%) computed tomography (13 patients, 27%). Conclusion: Higher incidence of PVT was seen among patients with chronic liver disease. Prothrombotic states like myeloproliferative disorders and coagulation defects were the next common causes detected. PVT presenting as plain abdominal pain, pain associated with nausea, vomiting and diarrhea were seen in patients as well, thereby suggesting that PVT is an important differential diagnosis in patients presenting as abdominal pain with a negative work up for common causes. With the help of widespread and improved imaging techniques, earlier diagnosis of PVT can be achieved and early intervention can greatly reduce the morbidity of patients.

Biography

Radhakrishnan N is currently pursuing DM in Medical Gastroenterology in Institute of Medical Gastroenterology, Madras Medical College and RGGGH, Chennai, India. He has completed his Masters, MD in Internal Medicine from the same institute.