A thrombophilia panel revealed decreased activity of antithrombin III, factor II, and protein C. Thorough preoperative history-taking and postoperative primary care follow-up are essential, particularly in patients with multiple thromboembolic risk factors. The unexpected role of untreated psoriasis as a potential contributor to PVT highlights the need for further research into the systemic effects of chronic inflammatory conditions. The gene discussed is SERPINC1; the disease is Rare hereditary thrombophilia.