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Patient with Acute-On-Chronic Cholecystitis Complicated by Portal Vein Thrombosis Following "Long COVID-19": A Case

Amy Liu1, Victoria A Hodkiewicz1, Meredith Benson1

  • 1Department of Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|May 15, 2026
PubMed

Portal vein thrombosis (PVT) is a rare but serious complication of hypercoagulable states or conditions that increase portal pressure, such as liver cirrhosis, inherited or acquired coagulation cascade abnormalities, myeloproliferative disorders, malignancy, inflammation, or infection. COVID-19 has been associated with a prothrombotic state, leading to both arterial and venous thromboses. Here, we present a patient with minimal hypercoagulable risk factors who presented with PVT and acute-on-chronic cholecystitis with bacteremia, likely provoked by residual hypercoagulability from a "long COVID-19" syndrome. An 81-year-old male developed PVT as a complication of acute-on-chronic cholecystitis, with contributing factors potentially including hypercoagulability related to prior COVID-19 infection more than 4 months prior. PVT should remain a diagnostic consideration in patients with various hypercoagulable risk factors, including long COVID-19, who present with relevant clinical findings. There should be a low threshold for the pursuit of further diagnostic imaging, given the serious consequences of delayed diagnosis.

Keywords:
COVID-19case reportcholecystitishypercoagulabilityportal vein thrombosis

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