Extrahepatic portal vein thrombosis in a pregnant patient wi
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Extrahepatic portal vein thrombosis (EHPVT) is an obstruction of the extrahepatic vein with or without involvement of the intrahepatic portal vein or the splenic or superior mesenteric veins.1 Globally, cirrhosis of the liver is the foremost cause of portal hypertension, followed by extrahepatic portal vein obstruction (EHPVO).

In developing countries EHPVO accounts for 35%–40% of cases of portal hypertension. Most cases of non-cirrhotic portal vein thrombosis are caused by more than one factor, with thrombophilic conditions accounting for 60% of cases. Pathophysiological research revealed that a COVID-19 infection is a cause of thrombosis, and therefore if anyone develops COVID-19 during pregnancy the patient will have higher chances of thrombotic events.

A COVID-19 infection predisposes the infected person to thrombotic events. Myocardial infarction, acute limb ischaemia, mesenteric artery thrombosis and pulmonary embolism are all well-documented complications of this infection. Here we describe a pregnant patient who presented with obstructed labour with asymptomatic COVID-19 infection and developed ascites during the postoperative period. Further work-up of the patient revealed portal hypertension due to portal vein thrombosis (PVT).

As the patient was healthy before this index pregnancy, a causative link between COVID-19 and PVT cannot be ruled out. Her COVID-19 infection progressed to a moderate disease. She was managed with steroids and appropriate antibiotics for secondary bacterial peritonitis. She was finally discharged after 2.5 months of multidisciplinary treatment. This is a case of a survivor of complications due to pregnancy, COVID-19 and extrahepatic portal vein obstruction.

Source: https://casereports.bmj.com/content/14/8/e243697?rss=1
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