Portal vein thrombosis after anatomical liver resection: case report
Abstract
Background. Portal vein thrombosis is a polyetiological
life-threatening complication of various thrombophilic conditions. According to
some reports, after a liver resection, the frequency of this complication
is 3.6-9.1%. Up to a quarter (21-24%) of all cases of portal vein thrombosis,
it is associated with malignant neoplasms of the abdominal organs.
Polyetiology of this complication, particularly in patients after surgical
procedures, defines a variety of possible clinical situations of undoubted
clinical interest.
The aim of this work is to present a clinical case of
postoperative thrombosis of the portal vein (Grade IV by Yerdel) with effective
treatment due to etiotropic therapy.
Material and methods. A 68 years woman with intrahepatic cholangiocarcinoma
6 days after the right-hemihepatectomy performed without the Pringle-maneuver,
developed portal vein trunk thrombosis.
Results. The patient had a whole range
of possible etiological factors of thrombosis. Despite its massive character
(Grade IV on Yerdel), carrying out etiotropic therapy led to the patient's
recovery. Conclusion. Identification of all risk factors for thrombosis,
in particular anamnestic data on the possible presence of antiphospholipid
syndrome, should determine the change in the volume of preoperative
examination and preoperative preparation. Etiotropic treatment determines
its effectiveness even with massive thrombosis.
Keywords:portal vein thrombosis, liver resection, postoperative thrombosis, antiphospholipid syndrome
Funding. The study had no sponsor
support.
Conflict of interests. The authors declare no
conflict of interests.
Contribution. Article writing, analysis
of literature and preparation of descriptive and analytical parts of the work -
Semenkov A.V.; preparation of the initial project, data collection, clinical
management - Bachewskaya V.A.; conceptualization, viewing and editing - Sorokina
L.S.; preparation and presentation of the illustrative part of the work -
Yurichenko Yu.Yu.; preparation of a descriptive part on instrumental
examination methods - Shchekoturov I.O.
For citation: Semenkov A.V., Bachewskaya
V.A., Sorokina L.S., Yurichenko Yu.Yu., Shchekoturov I.O. Portal vein
thrombosis after anatomical liver resection. Case report. Clinical and
Experimental Surgery. Petrovsky Journal. 2020; 8 (4): 154-60. DOI: https://doi.org/10.33029/2308-1198-2020-8-4-154-160 (in Russian)
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