A Rare Case of Non-cirrhotic Acute Portal Vein Thrombosis With Gallbladder Infarction

TL;DR

A rare case of non-cirrhotic portal vein thrombosis with gallbladder infarction is reported, emphasizing the need for proper imaging techniques for diagnosis.

Contribution

The paper presents a rare clinical case highlighting the limitations of arterial-phase CT in diagnosing acute portal vein thrombosis.

Findings

Arterial-phase CT failed to detect acute portal vein thrombosis in the initial scan.

Late-phase CT confirmed PVT in the left branch and gallbladder infarction.

Gallbladder infarction due to PVT is uncommon and requires prompt anticoagulation.

Abstract

Non-cirrhotic portal vein thrombosis (PVT) is rare, and early initiation of anticoagulation therapy is crucial for recanalization and preventing complications.

A man in his 50s presented to the emergency department with acute back pain. His vital signs and laboratory results were normal, showing no signs of infection. An initial computed tomography (CT) scan with intravenous contrast in the arterial phase showed no abnormalities. However, on the third day, a CT scan in the late phase confirmed PVT in the left branch, along with gallbladder infarction.

This case highlights the limitations of arterial-phase CT in diagnosing acute PVT, which often extends to the splenic vein or superior mesenteric venous arches and may lead to intestinal infarction, although gallbladder infarctions remain rare.

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