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Brief ReportBrief Report

Portal Vein Thrombosis: An Unexpected Finding in a 28-Year-Old Male With Abdominal Pain

Jason L. Ferguson and Duane R. Hennion
The Journal of the American Board of Family Medicine May 2008, 21 (3) 237-243; DOI: https://doi.org/10.3122/jabfm.2008.03.070157
Jason L. Ferguson
DO
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Duane R. Hennion
MD
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    Figure 1.

    Selected computed tomography image with arrow indicating thrombosis within the portal vein and evidence of cavernous formation.

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    Table 1.

    Initial Laboratory Results

    Laboratory ExamResultReference Range
    White blood cell count3,200 cells/mm33.9 to 10.6
    Hemoglobin14.5 g/dL13.3 to 17.7
    Hematocrit43.2%40.0 to 53.1
    Platelets99,000/mm3150 to 440
    AST35 IU/L0 to 37
    ALT51 IU/L0 to 51
    GGT38 IU/L11 to 51
    Alkaline phosphatase127 IU/L38 to 126
    Total bilirubin0.8 mg/dL0.2 to 1.0
    Direct bilirubin0.2 mg/dL0 to 0.3
    Amylase47 IU/L30 to 110
    Lipase29 IU/L0 to 190
    Blood urea nitrogen10 mg/dL6 to 20
    Creatine –serum0.7 mg/dL0.8 to 1.4
    Prothrombin time13.9 sec11.7 to 14.2
    INR1.11.0
    Partial thromboplastin time30 sec24 to 36
    • AST, aspartate transaminase; ALT, alanine aminotransferase; GGT, gamma glutamyltransferase; INR, international normalized ratio.

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    Table 2.

    Hypercoagulable Laboratory Results

    StudyResultInterpretation
    Factor V Leiden mutationGenotype: R/RNormal genotype
    Prothrombin mutationGenotype: G/AHeterozygous positive
    Antithrombin III83% Activity seenNormal activity
    Protein C Deficiency87% Activity seenNormal activity
    Protein S Deficiency107% ActivityNormal activity
    Homocysteine7.3 μ mol/dL normal valueNormal value
    Anticardiolipin antibodyIgA: 1.9Normal limits
    IgG: 2.8
    IgM: 1.8
    Lupus anticoagulant antibody screening through Russell's viper venom assay35 secondsNormal
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    Table 3.

    Hypercoagulable Etiologies

    Thrombophilic DisordersLocal Factors
    Inherited DisordersAcquired DisordersInflammatoryRelated to Surgery
    Factor V Leiden mutationMyeloproliferative disordersCirrhosisPost liver transplant
    Prothrombin mutationMalignancySepsisSplenectomy
    Antithrombin IIIAntiphospholipid syndromePancreatitis/cholecystitisColectomy
    Protein C deficiencyAnticardiolipin antibodyDiverticulitisUmbilical vein catheterization
    Protein S deficiencyParoxysmal nocturnal hemoglobinuriaAppendicitisPortacaval shunting
    HyperhomocysteinemiaPeptic ulcer disease
    Oral contraception pillsInflammatory bowel disease
    Pregnancy/postpartumBlunt abdominal trauma
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The Journal of the American Board of Family Medicine: 21 (3)
The Journal of the American Board of Family Medicine
Vol. 21, Issue 3
May-June 2008
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Portal Vein Thrombosis: An Unexpected Finding in a 28-Year-Old Male With Abdominal Pain
Jason L. Ferguson, Duane R. Hennion
The Journal of the American Board of Family Medicine May 2008, 21 (3) 237-243; DOI: 10.3122/jabfm.2008.03.070157

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Portal Vein Thrombosis: An Unexpected Finding in a 28-Year-Old Male With Abdominal Pain
Jason L. Ferguson, Duane R. Hennion
The Journal of the American Board of Family Medicine May 2008, 21 (3) 237-243; DOI: 10.3122/jabfm.2008.03.070157
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