Transhepatic fibrinolysis of mesenteric and portal vein thrombosis in a patient with ulcerative colitis: A case report

Abstract

To present a case of acute mesenteric and portal vein thrombosis treated with thrombolytic therapy in a patient with ulcerative colitis in acute phase and to review the literature on thrombolytic therapy of mesenteric-portal system. Treatment of acute portal vein thrombosis has ranged from conservative treatment with thrombolysis and anticoagulation therapy to surgical treatment with thrombectomy and/or intestinal resection. We treated our patient with intraportal infusion of plasminogen activator and then heparin through a percutaneous transhepatic catheter. Thrombus resolved despite premature interruption of the thrombolytic treatment for neurological complications, which subsequently resolved. Conservative management with plasminogen activator, could be considered as a good treatment for patients with acute porto-mesenteric thrombosis.