Etiology of portal vein thrombosis and factors affecting prognosis

Etiology of Portal Vein Thrombosis and Factors Affecting Prognosis Background: The early diagnosis and treatment of portal vein thrombosis is of great importance in the course of the disease. In our study, we aimed to find out the most common causes in the etiology of portal vein thrombosis, but to shed light on the less common etiological factors, to show the importance of early diagnosis and early treatment, to find out which findings are more guiding by scanning prognostic factors and to clarify the course of the disease. Materials and Methods: The study was carried out by retrospectively examining the medical records of 95 patients diagnosed with Portal Vein Thrombosis who applied to the Faculty of Medicine of Çukurova University between 2011-2019. The demographic features, laboratory findings, survival times, course of the portal vein thrombosis, etiology, clinical presentation, complications, diagnosis and treatment of the patients were examined. Results: The most common etiological factors in the group with malignant or cirrhosis are hepatocellular carcinoma (49.2%) and cirrhosis (33.8%), and in the group without malignant or cirrhosis MTHFR C677T mutation (20.1%) and myeloproliferative diseases (16.7%) was. Abdominal pain and splenomegaly were the most common form of clinical presentation in both groups, followed by bleeding in the malignant or cirrhosis group, and in the other. The most common complication was esophageal varices and splenomegaly in both groups. Low albumin was the most common laboratory finding with a rate of 69.5% in the total patient. Color doppler ultrasound was performed on a total of 48 patients, it was the most common screening and diagnostic tool, followed by dynamic magnetic resonance imaging with 40%. 37 patients had received various treatments. Recanalization was observed more frequently in acute patients (52.9%) receiving anticoagulant therapy. 14 patients died during their follow-up, 13 of them were male (P = 0.040), 12 were in the malignant or cirrhosis group (P = 0.044). Conclusion: In conclusion, portal vein thrombosis should be considered in the differential diagnosis of abdominal pain, acid and splenomegaly in middle-advanced elderly patients and the underlying local and then systemic factors should be investigated if necessary. Every patient diagnosed should be screened for varicose veins, and beta-blocker therapy should be extended as a primary prophylaxis. Anticoagulation therapy should be started immediately, if there is no contraindicated condition. KeyWords: Portal vein thrombosis, malignancy, anticoagulation, thrombophilic factors, encephalopathy