Abstract
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
cholecystitis - portal vein thrombosis - COVID-19 - hypercoagulability - case report
