Portal Vein Thrombosis in Cirrhosis: Challenges in Management and Approach, a Case Report
DOI:
https://doi.org/10.60591/crspmi.567Keywords:
Anticoagulants, Hemorrhage, Hypertension, Portal, Liver cirrhosis, Liver Transplantation, Portal Vein, Portasystemic Shunt, Transjugular Intrahepatic, Venous ThrombosisAbstract
Portal vein thrombosis is a common complication in cirrhosis, especially in patients with decompensated disease, associated hepatocellular carcinoma, or those awaiting liver transplantation. Anticoagulation is the first-line therapy to improve transplant feasibility and outcomes in this context, although bleeding risk, particularly in the presence of portal hypertension, adds a notable challenge and complexity to its management.
We report the case of a patient with cirrhosis who presented with gastrointestinal bleeding due to gastroesophageal variceal rupture and hepatic encephalopathy, complicated by porto-mesenteric thrombosis. While undergoing pre-liver transplantation workup and shortly following the beginning of anticoagulation, he developed a subdural hematoma, highlighting the complexity of risk-benefit assessment and therapeutic decision-making. Thus, this case report highlights the delicate balance between haemorrhagic risk and thrombotic benefit and supports individualized, multidisciplinary management of PVT in cirrhotic patients.
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Copyright (c) 2026 Patrícia Amaral de Almeida, Aurélie Plessier
This work is licensed under a Creative Commons Attribution 4.0 International License.
