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Abstract

Introduction
We present a case of a 70-year-old non-alcoholic non-circumcised patient with a past history of chronic liver disease CLD, complicated by portal vein thrombosis. He reported gradual abdominal distension and pain in right hypochondrium with inappetence. He had no history of hematemesis, temperature, and pale bowel movement or drug abuse. Physically, the patient was icteric, had bilateral pitting edema, hepatomegaly as well as splenomegaly. Laboratory examinations showed increased levels of serum bilirubin, transaminases, creatinine, and urea, hypoalbuminemia, and extended prothrombin time prothrombin-this suggests defective hepatic synthetic capability. Importantly, an alpha-fetoprotein (AFP) was strongly increased (>1000 ng /mL). Imaging showed signs of chronic liver disease and multiple liver lesions that pointed to hepatocellular carcinoma (HCC), and portal vein thrombosis. Liver biopsy showed the micronodular cirrhosis with no sign of steatosis or hepatic metabolic disease, thus fitting a diagnosis of cryptogenic cirrhosis.
Study Design: A Case Report.                                                                                                       .
Place and Duration of Study. Department of Medicine, Saidu Medical College Swat, Pakistan from june 2024 to dec 2024