Antiphospholipid syndrome can have various clinical presentations, two of t
he most common being arterial and venous thrombosis. It is, however, unusua
l for them to occur in combination. We report here a case of combined hepat
ic artery and segmental portal venous occlusion in a 32-year-old patient wh
o was shown to have a lupus anticoagulant. There have been no previous repo
rts of thrombosis occurring simultaneously in the coeliac axis and the port
al vein. Computerised tomography, Doppler ultrasound scanning and selective
visceral angiography were used to demonstrate the anatomical lesions. The
patient was treated medically with unfractionated heparin leading to a favo
urable clinical outcome. The diagnosis and management of this case is discu
ssed with reference to the current literature on visceral thrombosis and an
tiphospholipid a nti body syndrome. Copyright (C) 2000 S. Karger AG, Basel.