The following is the complete blood count (CBC) at the time of admission:
|WBC (109/L)||Hb (g/dL)||MCV (fL)||PLT (109/L)|
What’s what: WBC, white blood cell count; Hb, hemoglobin; MCV, mean cell volume; MCHC, mean cellular hemoglobin concentration; RDW-SD, red cell distribution width-standard deviation; platelets, PLT; Normal values: WBC 5-10 x 109/L, RBC 4-6 x 1012/L, Hb 12-16 g/dL, Hct 35-47%, MCV 80-100 fL, MCHC 32-36 g/dL, RDW-SD < 45 fL, platelets (PLT) 150-450 x 109/L
Other labs showed normal:
- Prothrombin time (PT)
- Activated partial thromboplastin time (aPTT)
- Urea, creatinine and electrolytes
- AST, ALT, alkaline phosphate and bilirubin
Expected lab tests in portal vein thrombosis:
- May show elevations in plasma levels of acute phase reactants.
- Liver tests typically normal because hepatic arterial blood flow compensates for decreased portal inflow, although a transient, moderate increase in serum aminotransferases is seen in some patients.
- In patients with bowel ischemia, laboratory testing may reveal
- Metabolic acidosis
- Signs of renal or respiratory failure
- Elevated hematocrit due to hemoconcentration
Which of the following imaging modalities is/are acceptable for diagnosing PVT?
The following are the imaging results from the patient:
Computed tomography angiography (CTA):
Guideline recommendations regarding diagnosis of portal vein thrombosis: