Successful treatment of acute symptomatic extensive portal venous system thrombosis by 7-day systemic thrombolysis

Fang-Bo Gao; Le Wang; Wen-Xiu Zhang; Xiao-Dong Shao; Xiao-Zhong Guo; Xing-Shun Qi

doi:10.4240/wjgs.v14.i9.1082

Successful treatment of acute symptomatic extensive portal venous system thrombosis by 7-day systemic thrombolysis

World J Gastrointest Surg. 2022 Sep 27;14(9):1082-1085. doi: 10.4240/wjgs.v14.i9.1082.

Authors

Fang-Bo Gao^{1

2}, Le Wang¹, Wen-Xiu Zhang¹, Xiao-Dong Shao¹, Xiao-Zhong Guo¹, Xing-Shun Qi³

Affiliations

¹ Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China.
² Postgraduate College, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.
³ Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China. xingshunqi@126.com.

Abstract

Acute portal venous system thrombosis (PVST) can cause acute mesenteric ischemia and even intestinal infarction, which are potentially fatal, and requires recanalization in a timely fashion. Herein, we report a 56-year-old man with acute non-cirrhotic symptomatic extensive PVST who achieved portal vein recanalization after systemic thrombolysis combined with anticoagulation. Initially, anticoagulation with enoxaparin sodium for 4 d was ineffective, and then systemic thrombolysis for 7 d was added. After that, his abdominal pain completely disappeared, and portal vein system vessels became gradually patent. Long-term anticoagulation therapy was maintained. In conclusion, 7-d systemic thrombolysis may be an effective and safe choice of treatment for acute symptomatic extensive PVST which does not respond to anticoagulation therapy.

Keywords: Anticoagulation; Deep vein thrombosis; Mesenteric vein; Portal vein; Thrombolysis; Thrombosis.