Successful Endovascular Treatment of Acute Portal and Superior Mesenteric Vein Thrombosis in a Non-Cirrhotic Patient

Abstract

Portal vein thrombosis (PVT) in the absence of cirrhosis is an uncommon but potentially life‑threatening condition. It is frequently associated with systemic prothrombotic disorders. Early identification of the underlying cause, evaluation of PVT extension and underlying complications, and appropriate therapeutic intervention are crucial for prognosis. This case describes a 62‑year‑old male presenting with acute abdominal pain, in whom imaging revealed PVT with extension to the superior mesenteric vein, without underlying cirrhosis. Despite prompt anticoagulation, endovascular treatment with catheter‑directed thrombolysis and mechanical thrombectomy was conducted, achieving successful recanalization. Etiological investigation excluded major thrombophilic conditions. Long‑term anticoagulation was maintained with favourable evolution. Non‑cirrhotic PVT requires early diagnosis and individualized management. Endovascular therapy should be considered in selected cases with a dismal prognosis and/or mesenteric involvement.