A Case Report of Idiopathic Portal Hypertension with Diffuse Portal Thrombosis after Splenectomy

Nobuhiro Kai, Ken Ikenaga, Kazuhide Ura, Kimirou Tanaka, Teiji Matsumoto, Toru Segawa, Koichi Motoshima, Tsukasa Tsunoda, Ryoichi Tsuchiya, Kunihide Izawa*

The Second Department of Surgery and *Department of Emergency, Nagasaki University School of Medicine

A case of idiopathic portal hypertension, in which diffuse portal thrombosis developed after splenectomy is reported. A 35 year old woman was referred to Nagasaki University Hospital because of pancytopenia and esophageal varices. Splenectomy and transection of the esophagus were performed. Postoperative portal thrombosis was detected by ultrasonography three days after surgery and thrombus was observed as an isohyperrechoic mass in the portal vein and decrease in flow volume and flow speed in the portal vein was also detected by the ultrasoic doppler method. Intravenous infusion of Urokinase, 240,000 units/day was effective in decreasing the thrombus. In these cases ultrasonography with doppler examination was useful for early diagnosis and follow-up portal thrombosis.

Key words
idiopathic portal hypertension, portal thrombosis after splenectomy, anticoagulant theraphy

Reprint requests
Nobuhiro Kai The Second Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto, Nagasaki, 852 JAPAN

Accepted
July 10, 1990

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