ABSTRACT

Objective: Portal vein thrombosis (PVT) is one of the rare causes of portal hypertension unrelated to chronic liver disease (CLD), which differs in its clinical course and treatment. Knowing the age, gender and etiological distribution of the disease is very important in follow-up and treatment. This study aims to review the etiological distribution of the disease.

Material and Methods: This study was designed to be descriptive and retrospective. Patients who were followed up on with the diagnosis of PVT in the Hacettepe University Faculty of Medicine Gastroenterology Department over the last 40 years were screened retrospectively. A total of 119 patients were selected after excluding CLD, cirrhosis, and portal vein obstruction due to any tumoral formations compressing the portal vein. Sociodemographic characteristics, laboratory, endoscopy, and imaging results of the patients were analyzed.

Results: Mean age of the patients was 45.5 ± 15.3, and the mean age at diagnosis was 36.0 ± 16.4. The number of female patients was slightly higher (female/male= 62/57). In patients who presented with nonspecific complaints such as abdominal pain, distension, and fatigue, the most common physical examination finding was splenomegaly. The majority of the patients had one or more thrombophilic factors in their etiology, according to our findings (10.0%/12 patients, 31.9%/38 patients, respectively). Myeloproliferative disease was detected in 25 patients (21.0%), and 14 patients (12.0%) were considered idiopathic. Protein C and S deficiency were the most common thrombophilia factors (27.7%/33 patients and 19.3%/23 patients, respectively).

Conclusion: In conclusion, non-cirrhotic PVT should be considered in every patient presenting with massive splenomegaly, variceal bleeding, abdominal pain, and pancytopenia, and these patients should be investigated for thrombophilia and myeloproliferative disease.

Keywords: Portal vein thrombosis, thrombophilia, myeloproliferative, cirrhosis, splenomegaly