Thrombosis of the Portal Vein with Recanalization in Hepatic Cirrhosis

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ACUTE thrombosis of the portal vein has been reported as a complication occurring in from 10 to 20 per cent of patients with cirrhosis of the liver.1–9 Symptoms and findings vary in relation to the type of onset of thrombosis and to the stage of hepatic disease. Although the complication is relatively rare, the true incidence is difficult to determine because diagnosis usually is not made with certainty before the death of the patient.

The dual purpose of this paper is to report the case of a patient with hepatic cirrhosis in whom an acute portal vein thrombosis developed, proved by means of splenoportography both before and after recanalization, and to describe the nature of the symptoms that initially led us to suspect this diagnosis.

Report of a Case

A 39-year-old man was admitted to the hospital in November, 1959, because of anorexia, bloating, and intermittent cramping in the region of the umbilicus, of one year's duration. The abdominal pain had increased during the month before admission, having been so severe as to have awakened the patient at night several times. Three weeks before admission, jaundice without itching, tremulousness, and abdominal distention developed, and the urine became dark. The patient reported having consumed five or six highballs daily during the past 10 years, but there was no previous history of jaundice, hepatic disease, or ingestion of chlorpromazine hydrochloride. Except for nervousness and intermittent episodes of hyperventilation, he had been in good health until the onset of his present illness. . .



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