Recurrent portal and superior mesenteric vein thrombosis in a patient with idiopathic portal hypertension

Idiopathic portal hypertension (IPH) is characterized by portal hypertension and splenomegaly without portal vein obstruction or significant liver disease. Although IPH may occasionally be accompanied by portal vein thrombosis (PVT) and extrahepatic portal vein thrombosis (EHPVT), recurrent PVT and EHPVT are very rare in IPH. Herein, we report the case of a 30-year-old male who developed IPH with recurrent PVT and EHPVT. Eleven years earlier, the patient had undergone splenectomy and endoscopic sclerotherapy due to hypersplenism and esophageal variceal bleeding, respectively. Ten years earlier, the patient had suffered recurrent esophageal variceal bleeding, which was treated via band ligation, and was diagnosed with IPH via portography and liver biopsy. Then, 8 years prior to presentation, the patient complained of acute abdominal pain and was diagnosed with PVT and EHPVT. After a 6-month course of anticoagulation therapy, the PVT and EHPVT resolved completely. However, 8 years later, he complained again of abdominal pain and was diagnosed with recurrent PVT and EHPVT.