Portal Vein Thrombosis with Sepsis Caused by Inflammation at Colonic Stent Insertion Site

Su Jin Choi; Ji Won Min; Jong Min Yun; Hye Shin Ahn; Deok Jae Han; Hyeon Jeong Lee; Young Ok Kim

doi:10.4166/kjg.2015.65.5.316

Journal List > Korean J Gastroenterol > v.65(5) > 1007375

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Choi, Min, Yun, Ahn, Han, Lee, and Kim: Portal Vein Thrombosis with Sepsis Caused by Inflammation at Colonic Stent Insertion Site

Case Report

Korean J Gastroenterol 2015;65(5):316-320.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.65.5.316

Portal Vein Thrombosis with Sepsis Caused by Inflammation at Colonic Stent Insertion Site

Su Jin Choi, Ji Won Min, Jong Min Yun, Hye Shin Ahn, Deok Jae Han, Hyeon Jeong Lee, Young Ok Kim

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Young Ok Kim, Department of Internal Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, 271 Cheonbo-ro, Uijeongbu 480-717, Korea. Tel: +82-31-820-3347, Fax: +82-31-847-2719, E-mail: cmckyo@catholic.ac.kr

Received 10 September 201419 November 2014 Accepted 20 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics.

Keywords: Portal vein thrombosis, Sepsis, Anti-bacterial agents, Inflammation

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Fig. 1.

Abdominal CT scan taken two months before admission. There is no evidence of portal vein thrombosis (arrowhead).

Fig. 2.

Abdominal CT scan at admission. (A) Portal vein thrombosis (arrowhead) is present in left portal vein. (B) Inflammatory fibrotic stricture is seen at anastomosis site but stent patency is maintained in de-scending colon (arrow).

Fig. 3.

Sigmoidoscopy findings. Inflammation is not evident at anastomosis stricture site where colonic stent had been inserted.

Fig. 4.

Follow-up abdominal CT scan. (A) Abdominal CT scan taken after 1 month shows improved portal vein thrombosis (arrowhead). (B) After 2 months, regression of portal vein thrombosis (arrow) and moderate amount of ascites are noted.

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