Lin Hugo You-Hsien, Lin Zu-Yau, Shih Paul Ming-Chen, Chuang Wan-Long
Division of Hepatobiliary Medicine, Department of Internal Medicine, Kaohsiung Medical University, Taiwan.
Kaohsiung J Med Sci. 2007 May;23(5):254-8. doi: 10.1016/S1607-551X(09)70406-1.
Portal venous thrombosis (PVT) is a condition associated with high morbidity. The etiologies of PVT include intra-abdominal inflammation or infection, surgical intervention, abdominal malignancies such as hepatocellular carcinoma (HCC) and pancreatic carcinoma, or abnormality in coagulation caused by various reasons such as liver cirrhosis. Management of PVT should be based on its etiology and the condition of the patient. We describe a cirrhotic patient with HCC who suffered from acute pancreatitis. PVT in the main trunk was detected at admission due to the episode of acute pancreatitis. The etiology of thrombosis was considered to be inflammation around the main portal trunk caused by pancreatitis rather than cirrhosis or HCC. We did not instigate any management for the thrombosis. Acute pancreatitis was relieved after conservative treatment. Follow-up imaging study performed 46 days after detection of thrombosis showed spontaneous complete resolution of the thrombus. Our experience may provide useful information for the management of such patients.
门静脉血栓形成(PVT)是一种发病率较高的疾病。PVT的病因包括腹腔内炎症或感染、手术干预、腹部恶性肿瘤,如肝细胞癌(HCC)和胰腺癌,或由各种原因引起的凝血异常,如肝硬化。PVT的治疗应基于其病因和患者的病情。我们描述了一名患有HCC的肝硬化患者,该患者患有急性胰腺炎。入院时因急性胰腺炎发作检测到主干门静脉血栓形成。血栓形成的病因被认为是胰腺炎引起的门静脉主干周围炎症,而非肝硬化或HCC。我们未对血栓形成采取任何治疗措施。保守治疗后急性胰腺炎得到缓解。血栓形成检测46天后进行的随访影像学检查显示血栓自发完全溶解。我们的经验可能为这类患者的治疗提供有用信息。