Mesenteric and portal vein thrombosis in a young patient with protein S deficiency treated with urokinase via the superior mesenteric artery.
A 32-year-old man, who was previously healthy, had acute abdominal pain without peritonitis. Diffuse mesenteric and portal vein thrombosis were shown by means of a computed tomography scan. A protein s deficiency was found by means of an extensive workup for hypercoagulable state. Successful treatment was achieved with urokinase infusion via the superior mesenteric artery without an operation. This represents an attractive alternative approach to treating patients with this disease. The previous standard of operative intervention(1) can now be reserved for complications, such as bowel infarction with peritonitis, or for those patients with absolute contraindications to thrombolytic therapy.
Ludwig
D J
DJ
Section of General Surgery, Department of Interventional Radiology, Virginia Mason Medical Center, Seattle, WA 98111, USA.
Hauptmann
E
E
Rosoff
L
L
Neuzil
D
D
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use*; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D018455:Protein S Deficiency / Q000150:complications*; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator