Fang-Bo Gao, Le Wang, Wen-Xiu Zhang, Xiao-Dong Shao, Xiao-Zhong Guo, Xing-Shun Qi, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Author contributions: Qi XS conceived this manuscript; Zhang WX, Guo XZ, and Qi XS treated this case; Gao FB, Wang L, and Qi XS followed this case; Gao FB and Qi XS drafted the manuscript; Gao FB, Wang L, Zhang WX, Shao XD, Guo XZ, and Qi XS revised the manuscript; all authors have made an intellectual contribution to the manuscript and approved the submission.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Xing-Shun Qi, MD, PhD, Associate Professor, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110840, Liaoning Province, China. xingshunqi@126.com
Received: April 29, 2022 Peer-review started: April 29, 2022 First decision: May 29, 2022 Revised: June 1, 2022 Accepted: August 15, 2022 Article in press: August 15, 2022 Published online: September 27, 2022 Processing time: 146 Days and 7.4 Hours
Abstract
Acute portal venous system thrombosis (PVST) can cause acute mesenteric ischemia and even intestinal infarction, which are potentially fatal, and requires recanalization in a timely fashion. Herein, we report a 56-year-old man with acute non-cirrhotic symptomatic extensive PVST who achieved portal vein recanalization after systemic thrombolysis combined with anticoagulation. Initially, anticoagulation with enoxaparin sodium for 4 d was ineffective, and then systemic thrombolysis for 7 d was added. After that, his abdominal pain completely disappeared, and portal vein system vessels became gradually patent. Long-term anticoagulation therapy was maintained. In conclusion, 7-d systemic thrombolysis may be an effective and safe choice of treatment for acute symptomatic extensive PVST which does not respond to anticoagulation therapy.
Core Tip: The present case suggests that systemic thrombolysis should be safe and effective for acute extensive portal venous system thrombosis, if it is unresponsive to anticoagulation.
