In cirrhotic patients, portal venous thrombosis (PVT) is common, but usually asymptomatic and found incidentally. The study aimed to investigate the prevalence and clinical characteristics of advanced PVT among cirrhotic patients with a recent episode of gastroesophageal variceal hemorrhage (GVH).
The cirrhotic patients, who had recently suffered from GVH and were admitted for further treatment to prevent variceal rebleeding, were retrospectively recruited. Hepatic venous pressure gradient (HVPG) measurements, contrast-enhanced computed tomography (CT) examinations of the portal vein, and endoscopic examinations were performed. PVT was diagnosed by CT examination and classified as mild or advanced.
A total of 356 patients were enrolled, and 80 (22.5%) of whom had advanced PVT. More white blood cell counts and higher serum D-dimer levels were found in advanced PVT patients than in the patients with mild and no PVT. Among those with advanced PVT, HVPG was lower and fewer patients had values exceeding 12 mmHg, but both Grade III esophageal varices and varices with red signs were more prevalent. In multivariate analysis, white blood cell count (OR = 1.401, 95% CI, 1.171-1.676, P < 0.001), D-dimer level (OR = 1.228, 95%CI, 1.117-1.361, P < 0.001), HVPG (OR = 0.942, 95% CI, 0.900-0.987, P = 0.011), and Grade III esophageal varices (OR = 4.243, 95% CI, 1.420-12.684, P = 0.010) were associated with advanced PVT.
Advanced PVT, which is associated with a more severe hypercoagulable and inflammatory state, causes severe pre-hepatic portal hypertension in cirrhotic patients with GVH. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.