# Managing Temporomandibular Joint Ankylosis Concurrent With Extrahepatic Portal Vein Obstruction: A Report of a Rare Case and Literature Review Investigating the Hypercoagulability Link

## TL;DR

This paper reports a rare case of a young girl with two uncommon conditions and explores their possible connection through a shared hypercoagulable state.

## Contribution

The paper presents a rare case linking temporomandibular joint ankylosis and extrahepatic portal vein obstruction through hypercoagulability.

## Key findings

- An 11-year-old female presented with TMJA and EHPVO, suggesting a possible shared pathophysiological mechanism.
- Literature review supports a potential link between hypercoagulability and both TMJA and EHPVO.
- Clinical management and surgical outcomes are discussed for this rare co-occurrence.

## Abstract

This report describes the understudied co-occurrence of temporomandibular joint ankylosis (TMJA) and extrahepatic portal vein obstruction (EHPVO), exploring a shared pathway involving hypercoagulability. TMJA is an acquired pathology where joint surfaces fuse, causing restricted mouth opening and facial asymmetry. Globally, TMJA is prevalent among 1.5 to 5 patients/million, with a higher incidence in developing countries. While trauma and infections often cause TMJA, the pathogenesis remains unclear in many cases. Recent literature notes a link between TMJA and EHPVO, a noncirrhotic vascular disorder causing portal hypertension and upper gastrointestinal bleeding in children. Prothrombotic disorders such as protein C and S deficiency may contribute to EHPVO, mirroring TMJA's association with hypercoagulability. This report focuses on an 11-year-old female diagnosed with TMJA, accompanied by a history of ear infection and concurrent EHPVO. We further presented clinical observations, surgical interventions, and outcomes alongside a literature review to understand the probable connection between EHPVO and TMJA.