Abstract

Introduction: Portal vein thrombosis (PVT) is a rare condition caused by the blockage or narrowing of the portal vein by a thrombus. It is mostly linked to the presence of an underlying liver disease or prothrombotic disorder. Other uncommon causes of PVT are sepsis, pancreatitis, abdominal surgeries and drugs. We report a case of a patient with acute PVT with negative workup for the most common etiologies. As a pertinent finding, our patient received the J&J/Janssen COVID-19 vaccine one month prior to symptoms. Case Description/Methods: A 48 years-old-male with arterial hypertension who presented to the emergency department (ED) with abdominal pain of two weeks. The pain was described as constant, sharp, of moderate intensity, localized to the epigastrium, without radiation, not associated to meals and alleviated by ibuprofen. He denied fever, nausea, vomiting, appetite or weight loss, diarrhea, or gastrointestinal bleed. He used to drink 12 beer cans every-other-day for the past year but quit two months before symptoms started. Upon further history we found that he received the first shot of J&J/Janssen COVID-19 vaccine a month prior. Laboratories were remarkable for marked leukocytosis (22 x 10

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