Abstract

A STUDY ON AETIOLOGICAL CAUSES AND CLINICAL MANIFESTATIONS OF PORTAL VEIN THROMBOSIS

Author(s): Radhakrishnan Natarajan1, Premkumar Karunakaran2, Venkateshwaran Arcot Rajeshwaran3, Kanisheikh Mohammed4, Ratnakar Kini5

BACKGROUND
Portal Vein Thrombosis (PVT) has become an increasingly recognisable disorder during evaluation of cases of abdominal pain with usage of widespread imaging techniques. VT can result due to various clinical conditions like chronic liver disease, infections, malignancies and hypercoagulable states.
The aim of the study is to observe the clinical presentation and to do the aetiological workup of cases of PVT in a tertiary care centre.
MATERIALS AND 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 January 2016-July 2017 were taken up for the study. The clinical presentation of the above patients was observed and their aetiological workup were 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 diarrhoea and vomiting (5 patients, 14%), pain with nausea and anorexia (3 patients, 8%). Aetiological workup 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%) and computed tomography (13 patients, 27%).
CONCLUSION
Higher incidence of PVT were 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 diarrhoea were seen in patients as well thereby suggesting that PVT is an important differential diagnosis in patients presenting as abdominal pain with a negative workup 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.