门静脉-肠系膜上静脉广泛栓塞1例并文献复习

Portal vein thrombosis with superior mesenteric venous thrombosis: A case report and review of the literature

背景内镜下套扎术是食管胃静脉曲张出血的一线治疗方法.食管胃静脉曲张密集套扎后形成门静脉-肠系膜上静脉广泛新发血栓临床罕见.病例简介本文回顾性分析1例乙肝肝硬化脾切除术后食管胃静脉曲张出血患者,经食管胃底曲张静脉密集套扎治疗后出现门静脉-肠系膜上静脉广泛新发血栓,积极给予抗凝治疗后,新发血栓消失.结论对于肝硬化脾切除术后食管胃静脉曲张出血,尤其同时存在慢性门静脉血栓者,如需行套扎治疗,勿使套扎范围过密,不要追求一次性全部阻断血流,以防门静脉-肠系膜上静脉新发血栓形成.

BACKGROUND Endoscopic variceal ligation is a first-line treatment for esophagogastric variceal bleeding patients.Portal vein thrombosis(PVT)with superior mesenteric venous thrombosis(MVT)after intensive endoscopic variceal band ligation is extremely rare.CASE SUMMARY We report a rare case developing PVT and superior MVT after intensive endoscopic variceal band ligation.The thrombosis disappeared after full anticoagulation therapy.CONCLUSION Our case suggested that,when ligation is required to treat esophagogastric variceal bleeding patients with a history of splenectomy caused by liver cirrhosis,especially those with chronic portal vein thrombosis,if ligation is required,too dense ligation and blocking entire blood flow should be avoided to prevent the development of PVT or MVT.