A case of portal vein thrombosis associated with acute cholecystitis/pancreatitis or coincidence.
BACKGROUND
Portal vein thrombosis (PVT) is complex and risk factors include local precipitating factors and acquired and inherited factors. It occurs secondary to abdominal malignancy, infection or surgical intervention. PVT is commonly forgotten as a possible cause of abdominal pain. The clinical picture may vary but abdominal pain and low grade fever are the most characteristic picture.


METHODS
A 58-year-old male patient was admitted to our hospital complaining of abdominal pain for three days. CT scan revealed an edematous area around the portal vein. Doppler ultrasonography showed evidence of a portal vein thrombosis.


RESULTS
PVT can be diagnosed with CT and Doppler ultrasonography. Fresh thrombus can be undetected by sonography because of the low echogenicity but can be recognized by color Doppler ultrasonography. Treatment ranges from observation and bowel rest to surgical resection of bowel.


CONCLUSIONS
When we suspect a case of PVT, it should be treated at an early stage to prevent being lost in a diagnostic dilemma. The immediate use of anticoagulant could be important in preventing serious consequences of PVT.
El-Wahsh
Mohamed
M
London Bridge Hospital, 27 Tooley Street, London SE1 2PR, United Kingdom. elwahsh@liverupdate.com
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D041881:Cholecystitis, Acute / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011169:Portal Vein; D018570:Risk Assessment; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
D000900:Anti-Bacterial Agents