<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction</bold>: 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).<bold>Case presentation</bold>: 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.<bold>Conclusions</bold>: 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.</abstract>

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.

Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature

University of Medicine and Pharmacy Tirgu Mures

Victor Babes University of Medicine and Pharmacy Timisoara

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction: Extrahepatic portal vein thrombosis (EPVT) is the most frequent cause that leads to portal hypertension in non-cirrhotic patients. This condition...

Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature

Publié en ligne: 30 déc. 2017

Pages: 190 - 193

Reçu: 04 sept. 2017

Accepté: 24 nov. 2017

DOI: https://doi.org/10.1515/amma-2017-0038

Mots clés
extrahepatic portal and iliac veins thrombosis, complication of abdominal surgery, anticoagulation, long-term management

© 2017 Ioan Tilea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature

Publié en ligne: 30 déc. 2017

Pages: 190 - 193

Reçu: 04 sept. 2017

Accepté: 24 nov. 2017

DOI: https://doi.org/10.1515/amma-2017-0038

Mots clésextrahepatic portal and iliac veins thrombosis, complication of abdominal surgery, anticoagulation, long-term management

© 2017 Ioan Tilea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
extrahepatic portal and iliac veins thrombosis, complication of abdominal surgery, anticoagulation, long-term management