Benefsha Mohammad, Emilia Krol, Stuart Bussell, H Daniel Derbes
{"title":"Portal Vein Thrombosis After a Right Hemicolectomy: A Case Report.","authors":"Benefsha Mohammad, Emilia Krol, Stuart Bussell, H Daniel Derbes","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>The patient, a 43-year-old male, underwent uneventful laparoscopic right-sided hemicolectomy for a benign polyp, too large to be removed by colonoscopy. His postoperative course was uneventful; however, he returned 16 days after discharge with vague abdominal pain. A CT scan of his abdomen and pelvis showed extensive acute thrombus in portal, superior mesenteric, and splenic veins. After initial intravenous anticoagu- lation, follow-up imaging showed a persistent clot. The patient then underwent catheter-guided portal vein thrombolysis with tissue plasminogen activator (tPA), on postoperative day 29. He was doing well on 12-month follow-up. Portomesenteric thrombosis is a rare complication of laparoscopic surgery. It can occur even in the absence of any direct vascular trauma, as well as in delayed fashion after an initially uneventful procedure. Gold standard for treatment has not been developed and remains individualized based on the extent ofthe thrombus, the patient's clinical status, and condition of the affected bowel.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 1","pages":"23-26"},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Connecticut Medicine","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
The patient, a 43-year-old male, underwent uneventful laparoscopic right-sided hemicolectomy for a benign polyp, too large to be removed by colonoscopy. His postoperative course was uneventful; however, he returned 16 days after discharge with vague abdominal pain. A CT scan of his abdomen and pelvis showed extensive acute thrombus in portal, superior mesenteric, and splenic veins. After initial intravenous anticoagu- lation, follow-up imaging showed a persistent clot. The patient then underwent catheter-guided portal vein thrombolysis with tissue plasminogen activator (tPA), on postoperative day 29. He was doing well on 12-month follow-up. Portomesenteric thrombosis is a rare complication of laparoscopic surgery. It can occur even in the absence of any direct vascular trauma, as well as in delayed fashion after an initially uneventful procedure. Gold standard for treatment has not been developed and remains individualized based on the extent ofthe thrombus, the patient's clinical status, and condition of the affected bowel.
期刊介绍：
The Connecticut State Medical Society (CSMS) is a federation of eight component county medical associations, with a total membership exceeding 7,000 physicians. CSMS itself is a constituent state entity of the American Medical Association. Founded by the physician-patriots of the American Revolution, the Society operates from a heritage of democratic principles embodied in its Charter and Bylaws. The base of all authority in CSMS is, of course, the individual physician member. It is the decisions of members in their own county associations that ultimately determine the nature of the Society"s policies and activities.
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