Malignant PVT

45/M, no comorbidities K/c/o HBV related cirrhosis of liver with non-compliance to drugs Chief Complaints Abdominal distension since 1 months associated with pedal edema Physical Examination Ascites + Pedal edema + Investigations Bili = 1.2/0.8, OT/PT = 34/23, Alb = 2.3 , INR = 1.4 CT triple phase was done. Arterial and venous pahse are attached. Management What is the diagnosis and management?

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I usually use a DOAC over warfarin if a patient can afford as recent studies have shown a better rate of recanalization and lower bleeding risk with DOACs. Additionally, managing warfarin is a patient with cirrohsis is difficult as their PT/INR is already off. However, please go an EGD and band any varices, as bleeding from DOACs can be life threatening and no reversal agent is available in India.

Impressive PVT.

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