You are here

Portal Vein Thrombosis G013

Last amended 
7 November 2022
Current RMA Instruments

Reasonable Hypothesis SOP

107 of 2022

Balance of Probabilities SOP

108 of 2022

ICD Coding

ICD-10-AM Code: I81         

SOP Bulletin information on new instruments

SOP Bulletin 233   

Brief description

Portal vein thrombosis involves formation of a blood clot within the portal vein (or hepatic portal vein), a blood vessel that carries blood to the liver. Partial or complete blockage can lead to increased pressure in the portal vein system and reduced blood supply to the liver. This condition can be acute or chronic and most often occurs with cirrhosis of the liver. It may also occur more commonly in people suffering from malignancies (e.g. hepatocellular carcinoma), abdominal sepsis, pancreatitis, inflammatory bowel disease, systemic lupus erythematosus and other conditions associated with an increased risk of blood clots. Most people who develop portal vein thrombosis are asymptomatic but clinical manifestations can include abdominal pain and fever. Patients with chronic portal vein thrombosis can often present with gastrointestinal bleeding due to the development of complications. It is a treatable condition but extensive portal vein thrombosis can lead to life-threatening complications.

Confirming the diagnosis

The diagnosis is made from clinical evaluation and usually imaging is required for confirmation.

The relevant medical specialist is a vascular surgeon, haematologist or gastroenterologist.

Additional diagnoses covered by SOP
  • Pylephlebitis and suppuratives pyelephlebitis
Conditions not covered by SOP
  • Intentional occlusion by intravascular embolisation affecting the portal vein#
  • Portal vein thrombosis related to vaccine induced thrombotic thrombocytopaenia*
  • Oesophageal varices (common complication of portal vein thrombosis but can have other causes so treat as a separate diagnosis)#
  • Portal cholangiopathy/biliopathy (possible complication of chronic portal vein thrombosis but can have other causes so treat as a separate diagnosis)#
  • Portal hypertension (possible complication of chronic portal vein thrombosis but can have other causes so treat as a separate diagnosis)#

* another SOP applies

# non-SOP condition

Clinical onset

This condition can have variable clinical presentation with the onset being acute or chronic. Most people may be asymptomatic but others can present with serious complications. Acute portal vein thrombosis can result in abdominal pain and fevers.  

Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical presentation that is judged by a treating medical specialist to be related to the condition.

Clinical worsening

Treatment options will vary depending on the severity of the condition and features of the presentation. Anticoagulation or surgical intervention can often be considered to prevent progression and further complications. The only SOP worsening factor is for inability to obtain appropriate clinical management.