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Seong, Song, Cho, Lee, Woo, Jeong, Cho, and Han: Portal and Splenic Vein Thrombosis Successfully Treated with Anticoagulants in Acute Pancreatitis
Case Report

The Ewha Medical Journal 2014; 37(2): 116-120.

Published online: 30 September 2014

DOI: https://doi.org/10.12771/emj.2014.37.2.116

Portal and Splenic Vein Thrombosis Successfully Treated with Anticoagulants in Acute Pancreatitis

Ji Seok Seong, Jung Hoon Song, Kyung Pyo Cho, Jae Sung Lee, Yong Moon Woo, Beom Jin Jeong, Young Jun Cho, Yun Ju Han

Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea.

Corresponding author: Jung Hoon Song. Department of Internal Medicine, Seoul Red Cross Hospital, 9 Saemunan-ro, Jongno-gu, Seoul 110-747, Korea. Tel: 82-2-2002-8342, Fax: 82-2-2002-8347, love1226@hanmail.net

Received 6 February 2014       Accepted 20 February 2014

Copyright © 2014. Ewha Womans University School of Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.

Keywords: Portal vein thrombosis, Splenic vein thrombosis, Pancreatitis, Anticoagulants

Figures and Tables

Fig. 1
Computed tomography (CT) findings on admission. (A) Axial CT image shows necrotic changes in the pancreatic tail, fluid collections in the peripancreatic space (arrowheads) and portal vein thrombosis (arrow). (B) Coronal CT image shows portal vein thrombosis extension to splenic vein (arrow).
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Fig. 2
Follow-up computed tomography (CT) findings 7 days later. (A) Axial CT shows no improvement of acute pancreatitis (arrowheads) and the new appearance of left portal vein thrombosis (arrow). (B) Coronal CT shows the new appearance of left portal vein thrombosis (arrow).
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Fig. 3
Follow-up computed tomography (CT) findings 3 months later after anticoagulation. (A, B) CT findings show complete dissolution of portal and splenic vein thrombosis and great improvement of acute pancreatitis.
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Table 1
Summary of the reported cases of venous thrombosis in acute pancreatitis in Korea
emj-37-116-i001

PV, portal vein; SMV, superior mesenteric vein; SV, splenic vein; LMWH, low molecular weight heparin.

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