# Case Report: CT manifestations of acute portal vein thrombosis: cases report and literature review

## TL;DR

This case report describes two rare instances of acute portal vein thrombosis and highlights the importance of timely diagnosis and treatment using CT scans.

## Contribution

The paper presents two rare cases of APVT without cirrhosis or malignancy and emphasizes the role of contrast-enhanced CT in diagnosis and treatment guidance.

## Key findings

- Two patients with APVT were successfully diagnosed using contrast-enhanced CT and laboratory findings.
- Interventional therapy and pharmacological thrombolysis led to successful recanalization and recovery.
- Prompt diagnosis and treatment of APVT can prevent severe complications and improve outcomes.

## Abstract

Acute portal vein thrombosis (APVT) is a rare condition characterized by recent thrombus formation within the main portal vein or its branches. APVT occurring in patients without underlying cirrhosis or malignancy represents an even rarer presentation, with an estimated prevalence of 0.7–3.7 per 100,000 individuals. However, it can lead to severe complications, including intestinal infarction and mortality. We report two cases presenting with abdominal pain without an apparent precipitating factor. Both patients were diagnosed with APVT based on contrast-enhanced computed tomography (CT) findings, clinical presentation, and laboratory parameters. Depending on the extent of portal vein occlusion, distinct therapeutic approaches were employed: one patient underwent interventional therapy combining transjugular mechanical thrombectomy/thrombolysis with transjugular intrahepatic portosystemic shunt (TIPS) placement, while the other received systemic pharmacological thrombolysis. Successful portal vein recanalization was achieved in both patients, who subsequently recovered and were discharged. These cases underscore that prompt diagnosis and management of APVT can avert adverse clinical outcomes. Contrast-enhanced CT demonstrates significant value in classifying APVT, assessing disease severity, evaluating treatment response, and identifying complications, thereby providing crucial evidence for clinical decision-making.