Portomesenteric Thrombosis Secondary to Acute Cholecystitis: A Case Report.

Haseeb Ahmad Chaudhary,Khaldun Obeidat,Ibrahim Yusuf Abubeker,Kamran Mushtaq,Anand Kartha

doi:10.1155/2018/9409081

Haseeb Ahmad Chaudhary, Khaldun Obeidat + Show 3 more

Open Access

https://doi.org/10.1155/2018/9409081

Copy DOI

Abstract

Portomesenteric venous thrombosis (PMVT) is an uncommon clinical problem. Common risk factors include intra-abdominal infections, abdominal surgeries, malignancy, cirrhosis, and inherited thrombophilia. Early recognition and treatment of PMVT are important to avoid serious complications like mesenteric ischemia and infarction. Acute cholecystitis is a clinical condition encountered daily but rarely may be complicated by development of portomesenteric venous thrombosis. Only few cases have been reported of superior mesenteric vein thrombosis secondary to cholecystitis. We report a case of a forty-one-year-old male patient who developed partial portal and superior mesenteric vein thrombosis after mild acute cholecystitis for which surgery had been deferred. Patient had no other identifiable risk factors for thrombosis. Patient was successfully treated with 6 months of anticoagulation with warfarin and complete recanalization of portomesenteric veins was achieved at the end of treatment.

Highlights

The prevalence of portal vein thrombosis is about 1% in the general population [1]
We report a case of a forty-one-year-old male patient who presented to our emergency department with chief complaints of abdominal pain and was found to have right upper quadrant tenderness
Contrast-enhanced CT scan of abdomen diagnoses more than 90% of cases and is considered gold standard as it can diagnose potential complications like mesenteric ischemia and infarction [6]

Summary

Introduction

The prevalence of portal vein thrombosis is about 1% in the general population [1]. Wide variety of causes of portal and superior mesenteric vein thrombosis has been reported before [2]. The three main categorical groups are malignant thrombosis, cirrhotic PVT, and nonmalignant, noncirrhotic PVT [3]. The most common risk factors for PVT are cirrhosis, hepatobiliary malignancies, and pancreatitis [4]. Acquired thrombotic risk factors, such as latent myeloproliferative disorders and prothrombotic genetic defects, have been identified as major risk factors for PVT [5]. Recognition of PMVT is important as delayed diagnosis can lead to life threatening complication like mesenteric ischemia and infarction

Case Presentation

Discussion

Conclusion

Findings

Conflicts of Interest