Treatment-Portal vein thrombosis (PVT)

• Treatment: Acute: If noncirrhotic, LMWH → warfarin or DOAC × 6 mo, or indefinitely if irreversible cause. If cirrhotic, anticoag ↑ recanalization w/o ↑ bleeding (Gastro 2017;153:480); screen for high-risk varices prior to Rx (Nat Rev Gastro Hep 2014;11:435).

Chronic: Anticoag if noncirrhotic or hypercoag state. If cirrhotic, consider txp if sx or progression. In all, screen for varices; if present, variceal bleed Ppx prior to anticoag.