Inferior vena caval and right atrial thrombus complicating amoebic liver abscess.
We present the result of right atrial thrombectomy in a paediatric patient suffering from a right atrial thrombus due to amoebic liver abscess under total circulatory arrest. A 2-year old boy with amoebic liver abscess complicated by inferior vena cava (IVC) thrombus extending up to the right atrium (RA) was operated on in our institute. During the surgery, the thrombus was removed from the IVC and the RA under deep hypothermic circulatory arrest. After chest closure, open drainage of the abscess was performed. Metronidazole was given postoperatively for 2 weeks. The postoperative period was uneventful. There was rapid convalescence with complete resolution of the abscess. Anticoagulation with warfarin was started on the day following surgery and continued for 6 weeks. There was no recurrence of thrombosis or embolic events in the follow-up period. Extension of thrombus into the right atrium mandates an aggressive surgical approach which may prove life saving. It is crucial in the prevention of pulmonary embolism or Budd-Chiari syndrome, which may have an overall poor outcome.
Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research and Dr RML Hospital, New Delhi, India.
Mansoor
M
Siddiqui
Anubhav
A
Gupta
Aamir
A
Kazmi
Dinesh
D
Chandra
Vijay
V
Grover
Vijay
V
Gupta
D000925:Anticoagulants / Q000627:therapeutic use; D002675:Child, Preschool; D050792:Circulatory Arrest, Deep Hypothermia Induced; D004322:Drainage; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin
Amoebic liver abscess; Inferior vena cava thrombus; Right atrial thrombus