Thrombosis of the portal venous system following blunt abdominal trauma

Abstract

A 60-year-old man presented to the accident and emergency department with a 4-day history of abdominal pain following blunt abdominal trauma. An initial CT scan showed thickened walls of the proximal jejunum and thromboses in the portal, splenic and superior mesenteric veins. He was given warfarin and the abdominal pain resolved. A repeat CT scan 1 week later revealed significant resolution of the mural thickening and the portal vein thrombosis. A subsequent thrombophilia screen was negative and he continued taking oral anticoagulants for a total of 6 months. A repeat CT scan 3 months after presentation revealed complete recanalisation the portal venous system.

Conflict of interest statement

Competing interests None.

Figures

Figure 1

Abdominal CT scan showing splenic vein thrombosis (L, liver; S, spleen; SVT, splenic vein thrombosis).

Figure 2

Abdominal CT scan showing portal vein thrombosis (L, liver; S, spleen; SVT, splenic vein thrombosis).

Figure 3

Abdominal CT scan showing patent blood flow through the portal vein (L, liver; S, spleen; PV, portal vein).

Figure 4

Abdominal CT scan showing collaterals around the splenic hilum (C, collaterals; L, liver; S, spleen)