A CASE REPORT OF IDIOPATHIC PORTAL HYPERTENSION WITH A PORTAL VEIN THROMBUS AND MULTIPLE LIVER INFARCTIONS AFTER SPLENECTOMY

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  • 脾摘後門脈血栓により肝多発梗塞をきたした特発性門脈圧亢進症の1例

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Abstract

A case of idiopathic portal hypertension (IPH), in which portal vein thrombus and multiple liver necrosis developed after splenectomy is reported. A 63-year-old woman was referred to the department because of pancytopenia and esophageal varices. Splenectomy was performed. On 8th day after the operation, a low grade fever and elevations of GOT and GPT were recognized. CT findings indicated multiple hepatic infarctions, and US findings indicated a portal vein thrombus. She had been treated by anticoagulant drugs. After one month, no portal vein thrombus was seen, and multiple hepatic infarctions disappeared on CT findings. Thereafter the patient was successfully managed by oral anticoagulant therapy. It has been reported that liver infarction hardly occurs because the liver is controlled by both portal and arterial systems. There have been few cases causing multiple hepatic infarction due to portal vein thrombosis in a high rate, anticoagulant regimen should he started in an early time after splenectomy for prevention of the thrombosis in patients with IPH.

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