Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature
| Autor: | Elena Ardeleanu, Anca Negovan, Ioan Tilea, Radu Mircea Neagoe, Andreea Varga, Raluca Marginean, Cristina Maria Tatar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
extrahepatic portal and iliac veins thrombosis business.industry 030204 cardiovascular system & hematology long-term management medicine.disease complication of abdominal surgery Thrombosis Surgery 03 medical and health sciences 0302 clinical medicine Iliac veins cardiovascular system Medicine 030211 gastroenterology & hepatology General Pharmacology Toxicology and Pharmaceutics business anticoagulation General Dentistry Abdominal surgery |
| Zdroj: | Acta Medica Marisiensis, Vol 63, Iss 4, Pp 190-193 (2017) |
| ISSN: | 2247-6113 |
| Popis: | Introduction: Extrahepatic portal vein thrombosis (EPVT) is the most frequent cause that leads to portal hypertension in non-cirrhotic patients. This condition is related to systemic and local risk factors (such as inflammatory lesions, injuries to portal venous system by surgery, vascular procedures). Case presentation: A case of extended extrahepatic portal vein thrombosis and simultaneous thrombosis of left common iliac vein and inferior vena cava, appeared after abdominal surgery in a hypertensive, diabetic, 50 y.o. man is presented. An acute episode of abdominal pain was interpreted as an emergency and a surgical (initially laparoscopic and then open) procedure was planned in order to perform an appendectomy. Discharge diagnosis was hemoperitoneum secondary to iatrogenic rupture of sigmoid mesocolon provoked by trocar manipulation. Repeated imaging studies performed later revealed the thrombosis of portal vein with extension into right portal branch associated with superior mesenteric thrombosis and free-floating thrombus into left common iliac vein extended towards inferior vena cava. Surgical manoeuvres are considered as triggers of these thrombotic events. After 4 weeks of parenteral anticoagulation a partial recanalization of thrombi was identified, without bleedings. Conclusions: Acute EPVT needs a carefully management. Case is linked to abdominal surgery and requires prolonged anticoagulation related to simultaneous portal and iliac vein thrombosis. Associated conditions (hypertension and diabetes mellitus) must have an appropriate approach. After our knowledge this is the first case published in literature. |
| Databáze: | OpenAIRE |
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