Most portal vein thrombosis is formed on the basis of cirrhosis of the liver. Due to cirrhosis, it causes increased portal vein pressure, blocked venous return and slowed blood flow, leading to thrombosis. Huang Gang, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Guangzhou Medical University, due to portal hypertension, causes enlargement of the spleen and hypersplenism, resulting in decreased platelets, decreased hemoglobin, decreased white blood cells, etc. Therefore, the treatment of portal vein thrombosis is very difficult. On the one hand, the treatment of thrombosis requires anticoagulation, which can easily cause bleeding, and on the other hand, patients with low platelets can bleed easily and require treatment such as removal of the spleen, which is very risky and requires high surgical skills in the case of low platelets, so the majority of hospitals cannot do it. It takes a great deal of expertise to master the balance between the two aspects. The following is one of the many cases of portal vein thrombosis that I have done, and it is described as follows: Before the Spring Festival, Mr. Song’s son from Ningxia called and said that his father was reviewed at the local hospital and all the portal vein thrombosis was gone. What good news! The patient’s long-term cirrhosis led to portal vein thrombosis, and the platelets were very low, less than 30,000, which could not be treated in the local hospital. Later, he went to a famous Xi hospital in Xi’an, where he was hospitalized without any significant improvement, and the doctor said he needed surgery but it was very dangerous and could not be operated. The patient’s son finally contacted me after inquiring and asking around, and after consultation, first sent a CT film. After carefully reading the CT films, it was determined that only surgery could first solve the problem of portal vein thrombosis. A few days later, the patient and his son came all the way to Guangzhou. After adequate preoperative preparation and delicate surgery, he quickly recovered and was discharged from the hospital, took medication as required, and the thrombus disappeared completely. The details are described as follows. Patient Song Moumou, male, 55 years old, from Ningxia. He was admitted to the hospital on April 2011 due to “intermittent epigastric distension for more than 3 months”. The patient presented with intermittent abdominal distension with no obvious cause more than 3 months ago, accompanied by swelling of both lower extremities, which was obvious after eating and accompanied by reduced bowel movements. “, given anti-infection, acid control, liver protection and other related symptomatic treatment after the condition improved, the professor informed that due to the patient’s extremely low platelets, portal vein thrombosis could not be dealt with, discharged. He came to our hospital. After admission, he was treated with liver protection and blood thinning, and spleen surgery was performed under general anesthesia. Intraoperative observations: more clear, yellowish ascites was seen in the abdominal cavity. Cirrhosis was severe: atrophy was evident in both the right and left lobes, with pineapple-shaped nodules on the liver margins and surface, and small cysts were visible on the liver surface. The spleen was obviously enlarged, about 25×18 cm, with severe varices in the splenic hilum. The esophagogastric fundus and the vascular varices on the side of the gastric lesser curvature were obvious. External CT: cirrhosis, splenomegaly, portal hypertension, esophagogastric fundic varices, ascites, and gallbladder changes were considered as cholecystitis, and no significant abnormalities were seen in the pancreas and both kidneys. After comprehensive and careful postoperative treatment of liver protection and anticoagulation, the patient rapidly improved and was discharged with reduced portal vein thrombosis. After discharge, the patient took medication as required, regular checkups and adjustment of medication dosage, and now the portal vein thrombosis has all disappeared.