Abstract
The patient, a 41-year-old woman, developed acute portal vein thrombosis during the first trimester of pregnancy. She was admitted with severe epigastralgia and melena. An abdominal computed tomography revealed a thickened small intesinal wall and ascites. A superior mesenteric angiography revealed an occlusion of the portal vein involving the superior mesenteric vein and the development of pen-portal collateral circulation. The patient was found to be pregnant through an ultrasonography, and this was confirmed by an obstetrician. Though a definite relationship between thrombus formation and the pregnancy was unclear, the increased coagulability was considered undesirable, and an artificial abortion was performed.
Warfarin administration was subsequently continued successfully. The patient was not compatible with the criteria used for the diagnosis of extrahepatic portal vein occlusion in Japan because of the absence of portal hypertension. The patient's portal hypertension development will be monitored monthly from this time.
