A patient with thrombosis of the portal vein may be asymptomatic or have clinical symptoms depending on the extent and rapidity of development. Often diagnosis requires a high index of suspicion and identification of potential predisposing factors.
Acute thrombosis may present with:
(1) severe abdominal pain
(2) diarrhea
(3) signs of peritoneal irritation
(4) signs of bowel infarction and/or intestinal bleeding
A patient with portal hypertension may have:
(1) worsening ascites or ascites resistant to therapy
(2) bleeding esophageal varices with hematemesis and melena
In addition, the patient will have signs and symptoms of the precipitating condition(s).
Imaging studies (MRI, angiography) can be used to demonstrate the thrombosis.
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