Thrombosis in the portal vein (PVT) can occur at any point along its course from the junction of the splenic vein and the superior mesenteric vein [1]. Classically, PVT is described to present with sudden-onset right upper-quadrant pain, abdominal swelling/ascites and hepatomegaly [2]. In such cases, clinical suspicion is high and management is relatively straightforward with anticoagulation in the absence of contraindications. We analysed all cases of PVT in our institution over a two-year period to determine clinical presentation, imaging and management of the patients.