A 52-year-old man with a history of mild hepatitis C cirrhosis presented with a chief complaint of several weeks of postprandial abdominal pain and anorexia. He had no history of coagulopathy, ascites, varices, or hepatic encephalopathy.
Evaluation revealed portal venous thromboses, and he underwent catheter-directed thrombolysis with tissue plasminogen activator (tPA). He was admitted to the medical ICU for routine postprocedure monitoring while receiving continuous tPA. On admission, he was alert and oriented, jaundiced, and the examination was otherwise unremarkable. The hemoglobin level prior to the procedure was 12.5 g/dL. Following the procedure, hemoglobin was stable on two serial measurements. Platelet count was 126,000/μL, and renal function, electrolytes, and international normalized ratio were normal.