首页 | 本学科首页   官方微博 | 高级检索  
     


Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation
Authors: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
Affiliation:Departments of Gastroenterology, Radiology and Surgical Oncology, University of Tokyo, Tokyo, Japan. TATEISHIA-INT@h.u-tokyo.ac.jp
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.
Keywords:Down syndrome    mesenteric vein    portal vein    protein S deficiency    venous thrombosis
本文献已被 PubMed 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号