This protocol addresses a high-acuity presentation of chronic portal vein thrombosis (PVT) in which the patient develops life-threatening complications. The defining features of this scenario include:
In this setting, the initial step centres on surgical consultation to evaluate the extent of vascular involvement and assess bowel viability — a determination that directly guides further management. The complete structured regimen, including the full decision pathway, is available via the link below.
DOI: 10.1016/j.tvir.2025.101084
— In patients with acute life-threatening symptoms related to PVT, particularly with extensive involvement of the SMV, surgical consultation should be obtained, especially in cases involving bowel ischemia or bowel necrosis.
— Visual evaluation of the bowel may be required to assess viability.
— Multivisceral transplant of liver and small bowel may be considered for patients with Yerdel grade 4 PVT depending on local surgical expertise.
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