Hepatic Portal Vein Obstruction ( Ehpvo )

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Introduction: Extra-hepatic portal vein obstruction (EHPVO), i.e., in the absence of liver cirrhosis or abdominal cancer, is a rare manifestation of venous thrombosis that often leads to portal hypertension1.After prothrombin, factor V, next most common cause of thrombophilia is high plasma levels of coagulation factor VIII, which are present in approximately 20% of patients with deep vein thrombosis (DVT) of the lower limbs and increase the risk of the disease in a dose-dependent manner 2. Like fibrinogen, factor VIII is an acute phase reactant whose concentration rises in plasma in the presence of inflammation. However, high factor VIII levels are associated with an increased risk of DVT independently of the acute phase reaction3.

Case report: A 21-year-old male in good health and with no significant past medical history presented with abdominal pain for 2 months in epigastric and left hypochondrium. He is not on any drugs. History of similar complaints in his younger sister and she died 2 years back without any evaluation. A contrast enhanced computed tomography scan of the abdomen showed superior mesenteric vein thrombosis with multiple collaterals in perigastric and porta hepatis. A coagulation profile work-up was done. His factor VIII activity concentration was found to be 260% of normal (normal: 60-150). Analyses for prothrombin O20210A

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