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February 1963

Portal and Mesenteric Thrombosis

Arch Intern Med. 1963;111(2):208-213. doi:10.1001/archinte.1963.03620260068012

Acute portal thrombosis is usually characterized by ascites, hematemesis, vomiting, diarrhea, melena, abdominal pain, and ileus and runs its course without jaundice.1-5 The patient dies with symptoms of portal hypertension and infarction of the small bowel. In its chronic form, extensive collaterals develop, and portal hypertension becomes severe and progressive.2-3 Often, hepatic cirrhosis is concomitant and portal thrombosis may be a sequel, its frequency ranging from 2% to 11% of the cases of cirrhosis.6-12

We have recently studied an unusual case of subacute portal thrombosis that ran its course with jaundice, without ascites, and without symptoms of portal hypertension. Another feature of interest in this case is that, while portal thrombosis may be associated with mesenteric thrombosis,2-3 it is significant that the presenting symptoms should be those of intestinal obstruction, caused by the mesenteric venous thrombosis, and that the portal vein process should be initially silent,