Portal cavernoma: epidemiological, clinical, etiological and outcome profiles - a 15-year retrospective study in a University Hospital in Rabat, Morocco.
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Portal cavernoma is a late complication of chronic portal vein thrombosis and represents a major cause of non-tumoral portal hypertension, particularly in non-cirrhotic patients. Epidemiological data from North Africa remain scarce. This study aimed to describe the epidemiological, clinical, etiological, and outcome profiles of adult patients with portal cavernoma managed at a university hospital in Rabat, Morocco. We conducted a retrospective descriptive case series over 15 years (March 2010-May 2025), including adult patients with imaging-confirmed portal cavernoma followed at the Department of hepatogastroenterology C, Ibn Sina Hospital, Rabat, Morocco. Sixty-three patients were included, predominantly women, 73.0% (n=46). The mean age was 44 ± 13 years. Abdominal pain was the most frequent presenting symptom (46.0%; n=29). Esophageal varices were detected in 69.8% (n=44) of cases. An underlying etiology was identified in 76.2% (n=48) of patients, mainly inherited thrombophilic disorders. Long-term anticoagulation was prescribed in most patients and was associated with thrombotic stability during follow-up. Portal cavernoma cholangiopathy was the most frequent long-term complication (46.0%; n=29). Overall mortality was 9.5% (n=6). In this cohort from a university hospital in Rabat, Morocco, portal cavernoma predominantly affected young non-cirrhotic women and was mainly related to thrombotic disorders. Management relied on prolonged anticoagulation and systematic prevention of portal hypertension-related complications.