Portal vein thrombosis after laparoscopic colectomy: thrombolytic therapy via the superior mesenteric vein.
Portal vein thrombosis is a rare but well-reported complication after laparoscopic surgery. We present a case of portomesenteric venous thrombosis that occurred 8 days after a laparoscopic-assisted right hemicolectomy. Systemic anticoagulation failed to improve symptoms. The early postoperative state precluded the use of transarterial thrombolytic therapy. Transjugular intrahepatic catheter-directed infusion of urokinase into the superior mesenteric vein resulted in clearance of thrombus and resolution of symptoms. The published data on laparoscopy-induced splanchnic venous thrombosis and transjugular intrahepatic intramesenteric thrombolysis are discussed.
Department of Surgery, University of Connecticut School of Medicine, Saint Francis Hospital and Medical Center, Farmington, Connecticut 06030-3955, USA.
George A
GA
Poultsides
W Cannon
WC
Lewis
Robert
R
Feld
David L
DL
Walters
David A
DA
Cherry
Steven T
ST
Ruby
D003082:Colectomy / Q000009:adverse effects*; D003111:Colonic Polyps / Q000601:surgery; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D011169:Portal Vein; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator