Management of acute extensive portal vein thrombosis: the complexity and morbidity

Andy Ze Lin Chen; Matthew George Roy Allaway; Rafid Al-Asady; Arthur Richardson

doi:10.1136/bcr-2020-234282

Management of acute extensive portal vein thrombosis: the complexity and morbidity

BMJ Case Rep. 2020 Jun 21;13(6):e234282. doi: 10.1136/bcr-2020-234282.

Authors

Andy Ze Lin Chen¹, Matthew George Roy Allaway², Rafid Al-Asady³, Arthur Richardson²

Affiliations

¹ Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia andy.chen@health.nsw.gov.au.
² Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia.
³ Department of Radiology, Westmead Hospital, Westmead, New South Wales, Australia.

Abstract

A 62-year-old patient was admitted with an acute unprovoked portal vein thrombosis with splenic and mesenteric extension. His progress was complicated by progressive small bowel ischaemia and increasing clot burden despite systemic anticoagulation. This case report describes the use of catheter-directed thrombolysis via a transjugular intrahepatic portosystemic shunt, with the disease and its treatment complicated by a ruptured iatrogenic pseudoaneurysm, abdominal compartment syndrome and small bowel infarction necessitating extensive small bowel resection.

Keywords: gastrointestinal surgery; interventional radiology; portal vein.

Publication types

Case Reports

MeSH terms

Acute Disease
Humans
Mesenteric Veins
Middle Aged
Portal Vein*
Portasystemic Shunt, Transjugular Intrahepatic / methods*
Splenic Vein
Thrombolytic Therapy / methods*
Venous Thrombosis / complications
Venous Thrombosis / therapy*