Portal vein thrombosis (PVT) is a rare but serious condition that can lead to significant complications such as portal hypertension and gastrointestinal ischemia. This report discusses a unique case of extensive PVT involving the mesenteric veins, splenic infarction, gastroesophageal varices, and colorectal neoplasms with high-grade dysplasia. A 55-year-old woman with no notable medical history presented with recurrent abdominal pain after meals, poor appetite, and occasional vomiting. Imaging studies showed thrombosis in the portal vein, splenic vein, superior mesenteric vein, and inferior mesenteric vein, along with signs of splenic infarction. Endoscopic examinations revealed grade I esophageal varices, type 2 gastroesophageal varices, and several polyps in the colon and rectum. Histopathological analysis confirmed the presence of tubulovillous adenomas with high-grade dysplasia in the rectum, raising concerns about potential malignancy. Laboratory tests indicated microcytic hypochromic anemia and an elevated International Normalized Ratio (INR), which required anticoagulation treatment with warfarin. This case illustrates the complexities involved in diagnosing and managing PVT and its complications, especially when colorectal neoplasia is also present. A multidisciplinary approach is essential to tackle the various challenges posed by this condition and to improve patient outcomes. Further research into the connections between thrombosis, malignancy, and hypercoagulability is crucial for enhancing understanding and treatment options.
Key words: Portal vein thrombosis; Splenic infarction Mesenteric vein thrombosiss; Gastroesophageal varices; Colorectal neoplasms; High-grade dysplasia; Endoscopic submucosal dissection.
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