Portal Vein Thrombosis in Second Trimester of Pregnancy

Background: Acute portal vein thrombosis can be asymptomatic or may present with non-specific symptoms, making awareness and vigilance crucial among pregnant patients. The management of portal vein thrombosis (PVT) diagnosed during pregnancy is not well defined, as most existing data relate to cases diagnosed before pregnancy. Symptoms can resemble other pregnancy-related conditions, posing a challenge for clinicians. PVT during pregnancy can be effectively and safely managed with anticoagulation therapy. However, the potential for complications necessitates a multidisciplinary approach. This article outlines the case of PVT in a 39-year-old woman in the 14th week of gestation who was admitted through the emergency department due to an acute onset of abdominal pain predominantly in the epigastric and right hypochondriac regions. Methods: Abdominal ultrasonography revealed PVT, and treatment with low-molecular-weight heparins was commenced. Further investigation excluded any form of thrombophilic state. Results: The patient continued an adjusted dosage of thrombolytics after discharge until the end of her pregnancy and was reinstated for thromboprophylaxis following a caesarean section. Conclusions: A thorough diagnosis is vital for any abdominal pain in pregnancy. A personalised approach is essential for effectively managing PVT, highlighting the need for early detection and comprehensive care to optimise outcomes for both the mother and the offspring.