Thrombotic microangiopathy and fibrinolysis after hump-nosed viper envenomation.

Massive haemobilia due to rupture of a portal cavernoma is very rare. In our patient the cause for portal vein thrombosis remains obscure in the absence of umbilical sepsis, severe dehydration or a hypercoaguable state. Cavernous transformation has been documented even within a few days of the portal vein getting obstructed; and inflammation resulting from enteritis is a recognised cause of portal vein thrombosis [4]. However, enteritis is an unlikely explanation for portal vein obstruction in this infant because the diarrhoeal illness was mild and short lasting.