Portomesenteric Venous Thrombosis Presenting as Bowel Gangrene.

Portal vein thrombosis (PVT) typically arises in patients with underlying cirrhosis, hepatobiliary malignancies, abdominal inflammatory conditions, or hematologic disorders. However, in non-cirrhotic individuals, PVT is less common and may initially present with minimal symptoms, escalating significantly if it extends to the mesenteric veins. Here, we present the case of a 37-year-old male with combined portal and mesenteric venous thrombosis, manifesting as acute intestinal obstruction. He was successfully managed with an exploratory laparotomy, resection of gangrenous bowel, and systemic anticoagulation therapy. This case highlights the critical role of early surgical intervention in preventing mortality associated with non-cirrhotic PVT.