A Case of Postoperative Portal Vein Thrombus Which Caused Acute Liver Failure and Disappeared by Itself

Mitsuro Kanda, Takaya Miwa and Yuki Takeuchi

Department of Surgery, Nagoya Memorial Hospital

We report a peculiar case of portal vein thrombus in a 50-year-old woman who underwent upper gastric resection and splenectomy for intractable esophagogastric varices with cirrhosis in July 2004 and then was hospitalized in December 2004 due to consciousness disturbance, melena, evidencing symptoms of shock, marked liver disorder and anemia. Enhanced computed tomography indicated widespread portal vein thrombus from the right branch to superior mesenteric vein together with multiple hemorrhagic erosions of the remaining stomach found in upper gastrointestinal endoscopy. Based on a diagnosis of acute liver failure and upper gastrointestinal bleeding caused by portal vein thrombus, we started intensive treatment without thrombolytic therapy because gastric hemorrhaging was difficult to control endoscopically. One week later, the thrombus diminished and her general condition gradually improved. Seven weeks later, the thrombus had disappeared and she has had no recurrence. It is very rare for a portal vein thrombus causing acute liver failure to disappear so quickly and of its own accord.

Key words
portal vein thrombus, liver failure, upper gastric resection

Reprint requests
Mitsuro Kanda Department of Gastroenterological Surgery, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
February 18, 2009

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