AN UNUSUAL CASE OF PORTAL, SPLENIC AND MESENTERIC VENOUS THROMBOSIS PRESENTING WITH ACUTE ABDOMEN

Received 2019-04-11; Accepted 2019-05-11; Published 2019-05-29

Authors

  • Yeoh CN Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • R Nadiah Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Cheah SK Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Wan Mat WR Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • M Maaya Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • AR Raha Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.22452/jummec.vol22no1.2

Keywords:

Acute Abdomen, Mesenteric Vein Thrombosis, Non-Cirrhotic Vein Thrombosis, Portal Vein Thrombosis, Splenic Vein Thrombosis

Abstract

Porto-spleno-mesenteric vein thrombosis is a rare, life-threatening condition of extrahepatic portal venous system thrombosis. We report a rare case of a 49-year-old lady with late presentation of acute portal vein thrombosis in a non-cirrhotic liver with an incidental finding of left adnexal teratoma. She presented with a one-week history of severe abdominal pain associated with vomiting and diarrhea. She gave no history of prior risk for venous thromboembolism or liver diseases. Physical examination revealed a tender mass extending from suprapubic to left iliac fossa. Abdominal computed tomography scans showed a well-defined fatcontaining left adnexal mass, likely a benign teratoma, with no involvement of surrounding structures or calcification. There was evidence of porto-splenic-mesenteric vein thrombosis with liver infarction, bowel and splenic ischemia. Management of the extensive thrombosis causing multi-organ failure includes resuscitation, supportive care and treatment of thrombosis. Treatment options include early anticoagulation and if feasible, thrombolysis.

Keywords: Acute Abdomen, Mesenteric Vein Thrombosis, Non-Cirrhotic Vein Thrombosis, Portal Vein Thrombosis,Splenic Vein Thrombosis

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Published

2019-04-11

Issue

Section

Research article