Acil Serviste Karın Ağrısının Nadir Bir Nedeni: Portal Ven Trombozu

Year 2011, Volume: 2 Issue: 3, 17 - 19, 01.07.2011

Emin Uysal Erdem Çevik Orhan Çınar Yahya Ayhan Acar Mustafa Gök Deniz Arslan

Abstract

Portal ven trombozu nadir görülen, mezenterik iskemi ve enfarkt
komplikasyonları nedeniyle hızlı tanı konularak tedavi edilmesi
gereken klinik bir durumdur. Hastalar karın ağrısı, abdominal distansiyon,
ishal, bulantı, kusma, kanama gibi farklı semptomlarla
başvurabilmektedir. Acil servisimize karın ağrısı, yemek yiyememe,
kusma şikayetleri ile başvuran 69 yaşındaki erkek hastaya portal ven
trombozu tanısı konuldu. Etiyolojide tromboza neden olabilecek bir
patoloji tespit edilmeyen hastaya antikoagulan tedavi uygulandı. Bu
olguyu sunmaktaki amacımız acil servise karın ağrısı, bulantı kusma
şikayetleri ile başvuran hastalarda nadir görülüyor da olsa ölümcül
komplikasyonları ve erken tedavi gerektirmesi nedeniyle portal ven
trombozunu hatırlatmaktır

Keywords

Karın ağrısı, tromboz, portal ven

Rare Cause of Abdominal Pain at Emergency Department: Portal Vein Thrombosis

Abstract

Portal vein thrombosis is a rare condition that must be diagnosed and treated quickly because of its complications as mesenteric ischemia and mesenteric infarct. Patients may apply to emergency department with different complaints like abdominal pain, abdominal distension, diarrhea, nausea, vomiting and bleeding. A 69 years old male patient who presented to emergency department with abdominal pain, anorexia and vomiting was diagnosed as portal vein thrombosis. There was no comorbities that can cause thrombosis and the patient was treated with anticoagulant therapy. In this case report our aim is to emphasize that even though the portal vein thrombosis is a rare cause of abdominal pain it needs earlier therapy because of its lethal complications

Keywords

Abdominal pain, thrombosis, portal vein

References

• Ferguson JL, Hennion DR. Portal vein thrombosis: an unexpected finding in a 28- year-old male with abdominal pain. J Am Board Fam Maed, 2008;21:237-243.
• Condat B, Valla D. Nonmalignant portal vein thrombosis in adults. Nat Clin Pract Gastroenterol Hepatol 2006;3:505-515.
• Chawla Y, Duseja A, Dhiman RK. Review article: the modern management of portal vein thrombosis. Aliment Pharmacol Ther 2009; 30: 881-894.
• Portal Vein Obstruction, emedicine Web site. Available at: http:// emedicine.medscape.com/article/182425-overview. September 20, 2010. Accessed
• Bayraktar Y, Harmanci O. Etiology and consequences of throm- bosis in abdominal vessels. World J Gastroenterol 2006;12:1165- 1174.
• Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, Grandone E, Balzano A. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol 2004;40:736-74.
• Cohen J, Edelman RR, Chopra S. Portal vein thrombosis: a review. Am J Med 1992;92:173-182.
• Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H. Portal vein thrombosis; risk factors, clinical presentation and treatment. BMC Gastroenterol 2007;7:34.
• Kocher G, Himmelmann A. Portal vein thrombosis (PVT): a study of 20 non-cirrhotic cases. Swiss Med Wkly 2005;135: 372-376.
• Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasonogra- phy. 5th ed.Philadelphia: Elsevier-Saunders, 2005;598-602.
• Lai L, Brugge WR. Endoscopic ultrasound is a sensitive and spe- cific test to diagnose portal venous system thrombosis (PVST). Am J Gastroenterol 2004;99:40-44.
• Sugiyama M, Hagi H, Atomi Y, Saito M. Diagnosis of portal ve- nous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography. Abdom Imaging 1997;22:434-438.
• Condat B, Pessione F, Helene Denninger M, Hillaire S, Valla D. Recent portal or mesenteric venous thrombosis: increased recogni- tion and frequent recanalization on anticoagulant therapy. Hepa- tology 2000;32:466-470.
• Özkan U, Oğuzkurt L, Tercan F, Tokmak N. Percutaneous transhe- patic thrombolysis in the treatment of acute portal venous throm- bosis. Diagn Interv Radiol, 2006;12:105-107.