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A case of portal vein thrombosis associated with acute pancreatitis and cholangitis]
Authors:Dae Young Cheung  Jae Kwang Kim  Don Hyoun Jo  Hyun Jong Oh  Tae Ho Kim  So Yeon Lee  Soo Heon Park  Joon Yeol Han  Kyu Won Chung  Hee Sik Sun
Affiliation:Division of Gastroenterology, Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Yeongdeungpo-gu, Seoul, Korea.
Abstract:Portal vein thrombosis is a rare complication accompanied with acute pancreatitis or cholangitis/cholecystitis. The main pathogenesis of portal vein thrombosis in pancreatitis or cholangitis/cholecystitis are suggested to be venous compression by pseudocyst and an imbalance between the blood coagulation and fibrinolysis. In this case report, we experienced a 63 year old male who developed portal vein thrombosis later in the course of the treatment of acute gallstone pancreatitis with cholangitis/cholecystitis without any symptom or sign. The diagnosis of portal vein thrombosis was given on follow up CT scan and serum protein S activity was decreased to 27% in laboratory study. Immediate anticoagulation therapy with heparin and thrombolytic therapy with urokinase and balloon dilatation were performed. Despite the aggressive treatment, complete reperfusion could not be obtained. With oral warfarin anticoagulation, the patient showed no disease progression and was discharged. We report a case of portal vein thrombosis as a complication of acute pancreatitis and cholangitis/cholecystitis with a review of literatures.
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