[Bile duct lesions in portal vein thrombosis]

Four patients, three men aged 51, 45 and 31 and a woman aged 22 years with portal vein thrombosis presented with symptoms or signs of biliary obstruction. Laboratory examination showed cholestasis. Cholangiography demonstrated smooth indentations of the common bile duct consistent with external compression by collateral veins. The clinical course varied from spontaneous resolution of both symptoms and serum biochemical abnormalities to persistent cholestasis. In two patients, surgical treatment (splenorenal shunt and hepaticojejunostomy) failed due to the presence of numerous collateral veins. Biliary strictures secondary to formation of a portal cavernoma, so-called portal biliopathy, is a rather unknown complication of portal vein thrombosis. Although the majority of patients is asymptomatic, porto-systemic shunt surgery or endoscopic biliary intervention may be indicated in symptomatic cases.