Diffuse thrombus completely occluded in liver cirrhosis

Öz

Portal vein thrombosis is an important cause of presinuzoidal portal hypertension. Portal vein thrombosis usually occurs in patients with cirrhosis, malignant and prothrombotic disease. Patients with acute portal vein thrombosis have sudden onset. In chronic patients, portal hypertension and cavernous transformation developed. Diagnosis of portal vein thrombosis is utilized by Doppler ultrasonography, computed tomography and magnetic resonance imaging. In acute cases, low molecular weight heparin provides recanalization in more than half of the patients. In our case, a 74-year-old man presented with abdominal pain, nausea. Our patient had a thrombus that completely filled the portal vein. Although there was portal vein thrombosis in cirrhosis, thrombus was very common in our case.

Anahtar Kelimeler

• Portal ven trombozu,siroz

Karaciğer sirozunda portal veni tamamen tıkamış yaygın trombüs

Öz

Portal ven trombozu presinuzoidal portal hipertansiyonun önemli bir nedenidir. Portal ven trombozu genellikle sirozlu, malign ve protrombotik hastalığı olanlarda ortaya çıkmaktadır. Akut portal ven trombozlu hastalar ani başlangıçlıdır. Kronik hastalarda ise portal hipertansiyon ve kavernöz transformasyon gelişmiştir. Portal ven trombozunun tanısı doppler ultrasonografi, bilgisayarlı tomografi ve magnetik rezonans görüntüleme ile konulmaktadır. Akut vakalarda düşük molekül ağırlıklı heparin hastaların yarıdan çoğunda rekanalizasyonu sağlar. Bizim olgumuzda yetmiş dört yaşında erkek hasta karın ağrısı bulantı şikayetiyle başvurdu. Hastamızda portal veni neredeyse tamamen dolduran trombüs mevcuttu. Sirozda portal ven trombozu olmakla birlikte bizim vakamızda trombüs çok yaygındı.

Anahtar Kelimeler

• Portal ven trombozu,siroz

Kaynakça

1. 1. A. Squizzato W. Ageno A. Cattaneo N. Brumana A Case Report and Literature Review of Portal Vein Thrombosis Associated with Cytomegalovirus Infection in Immunocompetent Patients (Clinical Infectious Diseases, Volume 44, Issue 2, 15 January 2007, Pages e13–e16,https://doi.org/10.1086/509641)2. Damian J Harding, M Thamara PR Perera, Frederick Chen, Simon Olliff, and Dhiraj Tripathi Portal vein thrombosis in cirrhosis: Controversies and latest developments3. Cengiz Tavusbay, Erdinç Kamer, Turan Acar, İbrahim Kokulu, Haldun Kar, Özlem Gür,Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir Turkey(Turkısh Journal of Surgery 2017)4. Handa P, Crowther M, Douketis JD. Portal vein thrombosis: a clinician-oriented and practical review. Clin Appl Thromb Hemost 2014; 20: 498-506.5. İnan M, Tansel Sarıoğlu T, Serhat TH. Porto mesenteric venous thrombosis as a rare cause of acute abdomen in a young patient: What should be the process of diagnosis and management? Ulus Cerrahi Derg 2013; 29: 84-87.6. Uysal E, Çevik E, Çınar O, Acar Y.A, Gök M, Arslan D. Rare cause of abdominal pain at emergency department: portal vein thrombosis. JAEMCR 2011; 2: 17-197. Raja K, Jacob M, Asthana S. Portal Vein Thrombosis in Cirrhosis. J Clin Exp Hepatol 2014;4(4):320-31. 8. DeLeve LD, Valla DC, Garcia-Tsao G, American Association for the Study Liver Diseases. Vascular disorders of the liver. Hepatology 2009;49(5):1729-64. 9. Turnes J, García-Pagán JC, González M, Aracil C, Calleja JL, Ripoll C, et al. Portal hypertension-related complications after acute portal vein thrombosis: impact of early anticoagulation. Clin Gastroenterol Hepatol 2008;6(12):1412-7. 10. Plessier A, Darwish-Murad S, Hernandez-Guerra M, Consigny Y, Fabris F, Trebicka J, et al. Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study. Hepatology 2010;51(1):210-8. 11. Cerini F, Gonzalez JM, Torres F, Puente Á, Casas M, Vinaixa C, et al. Impact of anticoagulation on upper‐gastrointestinal bleeding in cirrhosis. A retrospective multicenter study. Hepatology DOI: 10.1002/hep.27783. 12. Blum U, Haag K, Rössle M, Ochs A, Gabelmann A, Boos S, et al. Noncavernomatous portal vein thrombosis in hepatic cirrhosis: treatment with transjugular intrahepatic portosystemic shunt and local thrombolysis. Radiology 1995;195(1):153- 7. 13. 18. Mann O, Haag K, Hauenstein KH, Rössle M, Pausch J. Septic portal vein thrombosis. Its successful therapy by local fibrinolysis and a transjugular portasystemic stent-shunt (TIPS). Dtsch Med Wochenschr 1995;120(36):1201-6.