Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation

Ayako Tateishi, Hiroshi Mitsui, Toshihiko Oki, Jo Morishita, Hisato Maekawa, Naohisa Yahagi, Toshiyuki Maruyama, Masao Ichinose, Shin Ohnishi, Yasushi Shiratori, Manabu Minami, Shinichiro Koutetsu, Nobukazu Hori, Toshiaki Watanabe, Hirokazu Nagawa, Masao Omata

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52 Citations (Scopus)

Abstract

Mesenteric vein thrombosis is generally difficult to diagnose and can be fatal. A case of extensive thrombosis of the mesenteric and portal veins was diagnosed early and successfully treated in a 26-year-old man with Down syndrome who was admitted to hospital because of abdominal pain, severe nausea and high fever. Ultrasonography revealed moderate ascites, and there was minimal flow in the portal vein (PV) on the Doppler examination. Computed tomography (CT) showed remarkable thickening of the walls of the small intestine and extensive thrombosis of the mesenteric, portal and splenic veins. Because neither intestinal infarction nor peritonitis was seen, combined thrombolysis and anticoagulation therapy without surgical treatment was chosen. Urokinase was administered intravenously and later through a catheter in the superior mesenteric artery. Heparin and antibiotics were given concomitantly. The patient's symptoms and clinical data improved gradually. After 10 days, CT revealed that collateral veins had developed and the thrombi in the distal portions of the mesenteric veins had dissolved, although the main trunk of the PV had not recanalized. The only risk factor of thrombosis that was detected was decreased protein S activity.

Original languageEnglish
Pages (from-to)1429-1433
Number of pages5
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume16
Issue number12
DOIs
Publication statusPublished - 2001 Jan 1
Externally publishedYes

Keywords

  • Down syndrome
  • Mesenteric vein
  • Portal vein
  • Protein S deficiency
  • Venous thrombosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Tateishi, A., Mitsui, H., Oki, T., Morishita, J., Maekawa, H., Yahagi, N., Maruyama, T., Ichinose, M., Ohnishi, S., Shiratori, Y., Minami, M., Koutetsu, S., Hori, N., Watanabe, T., Nagawa, H., & Omata, M. (2001). Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation. Journal of Gastroenterology and Hepatology (Australia), 16(12), 1429-1433. https://doi.org/10.1046/j.1440-1746.2001.02557.x