Objective To evaluate the prevalence and clinical characteristics of portal vein thrombosis (PVT) in cirrhotic patients with gastroesophageal variceal bleeding (GVB).

Methods The clinical data of the cirrhotic patients with GVB admitted in Zhongshan Hospital, Fudan University from 2015 to 2017 were retrospectively analyzed. The enrolled patients were divided into PVT and non-PVT groups according to the CT examination results of portal vein system. The clinical indices, such as laboratory findings, hepatic vein pressure gradient (HVPG), and endoscopic features, were compared between the two groups. The multivariate logistic regression analysis was used to evaluate the factors associated with PVT.

Results Three hundred and fifty-six patients were enrolled, and 117 (32.9%) had PVT. Compared to non-PVT group, patients in the PVT group had higher previous splenectomy rate, counts of white blood cells and platelets, D-dimer level, and lower hemoglobin level (P < 0.05), and higher rates of severe esophageal varices and esophageal varices with red sign (P < 0.05). There was no significant difference in HVPG between the two groups. The multivariate logistic analysis showed that white blood cell count increasing, D-dimer level elevating, and severe esophageal varices were independently associated with PVT (P < 0.05).

Conclusions The cirrhotic patients with GVB had a high PVT rate, and these patients with PVT had more severe inflammation and procoagulant reaction accompanied by more severe portal hypertension.