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Aetiology

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A third of cases are idiopathic. Recognised causes include:

  • hypercoagulable states:
    • including polycythaemia vera
    • pregnancy
    • antiphospholipid syndrome
    • essential thrombocythaemia
    • protein S / protein C / antithrombin III deficiency
  • myeloproliferative disease
  • contraceptive pill
  • posterior abdominal wall sarcomas
  • renal and adrenal tumours
  • hepatocellular carcinoma
  • hepatic infections, such as hydatid disease
  • trauma
  • congenital venous webs - idiopathic membranous stenosis of inferior vena cava between hepatic veins and right atrium is often associated with hepatic venous thrombosis
  • paroxysmal nocturnal haemoglobinuria
  • radiotherapy

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