Low-molecular-weight heparin followed by rivaroxaban for acute occlusive portomesenteric vein thrombosis in a cirrhotic patient treated with multiple endoscopic variceal procedures

Ann Hepatol. 2020 Sep-Oct;19(5):573-577. doi: 10.1016/j.aohep.2019.08.002. Epub 2019 Sep 5.

Abstract

Acute portomesenteric vein thrombosis is potentially lethal. In the present paper, a cirrhotic patient with a previous history of esophageal variceal bleeding presented with acute occlusive portomesenteric vein thrombosis, but achieved complete recanalization by low-molecular-weight heparin followed by rivaroxaban. Notably, no bleeding episode occurred during anticoagulation therapy. This case supported early initiation of anticoagulation in such patients.

Keywords: Anticoagulation; Bleeding; Liver cirrhosis; Portal vein thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / therapy*
  • Factor Xa Inhibitors / therapeutic use*
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic* / adverse effects
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Liver Cirrhosis, Alcoholic / complications*
  • Liver Cirrhosis, Alcoholic / diagnosis
  • Male
  • Mesenteric Veins* / diagnostic imaging
  • Middle Aged
  • Portal Vein* / diagnostic imaging
  • Rivaroxaban / therapeutic use*
  • Treatment Outcome
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / etiology

Substances

  • Factor Xa Inhibitors
  • Heparin, Low-Molecular-Weight
  • Rivaroxaban