Toyosaki Mitsunobu, Tsukadaira Mao, Matsuo Yushi, Sasaki Junichi
Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, JPN.
Department of Emergency Medicine, Fussa Hospital, Fussa, JPN.
Cureus. 2025 Feb 13;17(2):e78965. doi: 10.7759/cureus.78965. eCollection 2025 Feb.
Non-cirrhotic portal vein thrombosis (PVT) is rare, and early initiation of anticoagulation therapy is crucial for recanalization and preventing complications. A man in his 50s presented to the emergency department with acute back pain. His vital signs and laboratory results were normal, showing no signs of infection. An initial computed tomography (CT) scan with intravenous contrast in the arterial phase showed no abnormalities. However, on the third day, a CT scan in the late phase confirmed PVT in the left branch, along with gallbladder infarction. This case highlights the limitations of arterial-phase CT in diagnosing acute PVT, which often extends to the splenic vein or superior mesenteric venous arches and may lead to intestinal infarction, although gallbladder infarctions remain rare.
非肝硬化性门静脉血栓形成（PVT）较为罕见，早期启动抗凝治疗对于再通和预防并发症至关重要。一名50多岁的男性因急性背痛就诊于急诊科。他的生命体征和实验室检查结果均正常，未显示感染迹象。动脉期静脉注射造影剂后的初次计算机断层扫描（CT）未发现异常。然而，第三天的CT扫描晚期证实左支门静脉血栓形成，同时伴有胆囊梗死。该病例凸显了动脉期CT在诊断急性PVT方面的局限性，急性PVT常延伸至脾静脉或肠系膜上静脉弓，可能导致肠梗死，尽管胆囊梗死仍然罕见。
