Portal vein thrombosis with protein C-S deficiency in a non-cirrhotic patient

Abstract

There are several conditions that can lead to portal vein thrombosis (PVT), including including infection, malignancies, and coagulation disorders. Anew condition of interest is protein C and S deficiencies, associated with hypercoagulation and recurrent venous thromboembolism. We report the case of a non-cirrhotic 63-year-old male diagnosed with acute superior mesenteric vein thrombosis and PVT and combined deficiencies in proteins C and S, recanalized by short-term low molecular heparin plus oral warfarin therapy.

Keywords: Portal vein thrombosis; Mesenteric venous thrombosis; Protein C and S deficiency; Anticoagulant therapy; Transient elastography

Core tip: Abdominal pain, diarrhea, rectal bleeding, abdominal distention, ascites, anorexia, fever, lactacidosis, sepsis, and splenomegaly are common features of acute portal vein thrombosis (PVT). Etiological factors in non-cirrhotic PVT patients are prothrombotic states and local factors, although more than one factor is often identified. Our patient, a 63-year-old man, without personal or familial history of venous thromboembolism developed portal and mesenteric vein thrombosis after an acute gastrointestinal infection by Escherichia coli. Clinicians need to be aware of this potential complication in patients with persistent abdominal pain and ascites after abdominal infections.