Fig. 4.

A 25-year-old lady diagnosed with non-cirrhotic portal fibrosis with symptomatic splenomegaly and hypersplenism underwent laparoscopic splenectomy. She was discharged home on postoperative day (POD)-3 on oral aspirin therapy (75-mg once daily). She was readmitted on POD-18 with abdominal pain. (A) A Contrast-enhanced computed tomography (CECT) scan in the coronal plane revealing acute thrombosis (asterisk) in the main portal vein, extending into the superior mesenteric vein and the splenic vein. Initially, she was treated with therapeutic doses of low-molecular-weight heparin (enoxaparin), followed by an oral direct thrombin antagonist: dabigatran (150 mg twice daily). (B) A repeat CECT scan at the 6-month follow-up showed normal opacification of the main portal vein and the superior mesenteric vein. She achieved complete radiological resolution of the thrombosis after 6 months of oral anticoagulation without any subsequent clinical complications. Oral anticoagulation was continued for an additional 6 months after documenting the complete resolution of the splanchnic venous thrombosis on CECT.