Hepatic Vein Thrombosis Secondary to Protein C and S Deficiency

Hepatic Venous Outflow Tract Obstruction is obstruction of the hepatic venous outflow tract can be primary due to obstruction by thrombosis or secondary due to compression of hepatic vein, inferior vena cava or both. Causes being prothrombotic inherited or acquired. Classical clinical triad being abdominal pain, ascites, and tender hepatomegaly.Ultrasound, Computed Tomography or Magnetic Resonance Imaging of abdomen are required for confirmation.Long-term anticoagulation with vitamin K antagonists should be started. 24year female with abdominal distention and pain, having pallor, fluid distended abdomen. CT abdomen revealed an hypodense focal lesion in right lobe, ascites with Hepatic Vein Thrombosis. Haematology Low Functional antithrombin activity of 29 units, low Free Protein S Antigen of 42.8 units, very low Protein C functional activity of 16.5 units was observed. Frequency of prothrombotic hepatic venous outflow tract obstruction in India is more compared to west. So considered in all cases with acute, chronic liver disease with complications.