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

Table 1 Hypercoagulable etiologies

Thrombophilic disorders		Local factors
Inherited disorders	Acquired disorders	Inflammatory	Related to surgery
Factor V Leyden mutation	Myeloproliferative disorders	Cirrhosis	Post liver transplant
Prothrombin mutation	Malignancy	Sepsis	Splenectomy
Antithrombin III	Antiphospholipid syndrome	Pancreatitis/cholecystitis	Colectomy
Protein C deficiency	Anticardiolipin antibody	Diverticulitis	Umbilical vein catheterization
Protein S deficiency	Paroxysmal nocturnal hemoglobinuria	Appendicitis	Portocaval shunting
	Hyperhomocystein-emia	Peptic ulcer disease
	Oral contraception pills	Inflammatory bowel disease
	Pregnancy/post-partum	Blunt abdominal trauma

Table 2 Proposed mechanism for reduction in concentrations of procoagulant and anticoagulant proteins in patients with portal vein thrombosis

Hereditary or acquired thrombophilia

Reduced hepatic blood flow

Reduced synthesis

Portal hypertension

Portosystemic shunting

Clearance or consumption

Portal pyaemia or other local inflammatory disease

Portal vein thrombosis

Reduced levels of procoagulant and anticoagulant proteins