Limits...
The role of portal vein thrombosis in the clinical course of inflammatory bowel diseases: report on three cases and review of the literature.

Sinagra E, Aragona E, Romano C, Maisano S, Orlando A, Virdone R, Tesè L, Modesto I, Criscuoli V, Cottone M - Gastroenterol Res Pract (2012)

Bottom Line: Inflammatory bowel diseases are associated with an increased risk of vascular complications.In two of them, hepatic abscess was present.Furthermore, we performed a systematic review based on the clinical literature published on this topic.

View Article: PubMed Central - PubMed

Affiliation: Division of Internal Medicine, DIBIMIS, Ospedali Riuniti Villa Sofia-Vincenzo Cervello, Via Trabucco 180, 90100 Palermo, Italy.

ABSTRACT
Inflammatory bowel diseases are associated with an increased risk of vascular complications. The most important are arterial and venous thromboembolisms, which are considered as specific extraintestinal manifestations of inflammatory bowel diseases. Among venous thromboembolism events, portal vein thrombosis has been described in inflammatory bowel diseases. We report three cases of portal vein thrombosis occurring in patients with active inflammatory bowel disease. In two of them, hepatic abscess was present. Furthermore, we performed a systematic review based on the clinical literature published on this topic.

No MeSH data available.


Related in: MedlinePlus

CT scan showing gas in portal vein and a liver abscess.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3475311&req=5

fig3: CT scan showing gas in portal vein and a liver abscess.

Mentions: A 52-year-old male with a 20-year history of small bowel CD resected twice, after recent detection of stenotic recurrence, was admitted to our unit because of the onset of fever and diarrhoea. No history of previous thromboembolic events was present. Clinical examination showed fever (39°C) and painful abdominal distension; blood tests showed leucocytosis (16000 white blood cells (WBC)/mm3) and increased ESR (22 mm/Ih) and PCR (24 mg%). A CT scan showed gas in the portal vein and a liver abscess (Figure 3). Coagulation study (antithrombin, protein C and S activity, plasma homocysteine level, PT, and aPTT) did not show abnormalities and no mutations were detected in factor II, V, MTHFR, and PAI-I genes; anticardiolipin and antiphospholipid antibodies were negative; no mutation of JAK-2 gene was found. The patient was treated with ciprofloxacin and metronidazole and started LMWH (1 mg/kg/twice daily). After 4 weeks a CT scan showed patent portal and mesenteric vein. After drainage of abdominal abscesses, a surgical operation was performed for treatment of strictures and fistula. LMWH was stopped after three months. To date the patient is asymptomatic, with normal and patent portal vein detected with periodic US controls.


The role of portal vein thrombosis in the clinical course of inflammatory bowel diseases: report on three cases and review of the literature.

Sinagra E, Aragona E, Romano C, Maisano S, Orlando A, Virdone R, Tesè L, Modesto I, Criscuoli V, Cottone M - Gastroenterol Res Pract (2012)

CT scan showing gas in portal vein and a liver abscess.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475311&req=5

fig3: CT scan showing gas in portal vein and a liver abscess.
Mentions: A 52-year-old male with a 20-year history of small bowel CD resected twice, after recent detection of stenotic recurrence, was admitted to our unit because of the onset of fever and diarrhoea. No history of previous thromboembolic events was present. Clinical examination showed fever (39°C) and painful abdominal distension; blood tests showed leucocytosis (16000 white blood cells (WBC)/mm3) and increased ESR (22 mm/Ih) and PCR (24 mg%). A CT scan showed gas in the portal vein and a liver abscess (Figure 3). Coagulation study (antithrombin, protein C and S activity, plasma homocysteine level, PT, and aPTT) did not show abnormalities and no mutations were detected in factor II, V, MTHFR, and PAI-I genes; anticardiolipin and antiphospholipid antibodies were negative; no mutation of JAK-2 gene was found. The patient was treated with ciprofloxacin and metronidazole and started LMWH (1 mg/kg/twice daily). After 4 weeks a CT scan showed patent portal and mesenteric vein. After drainage of abdominal abscesses, a surgical operation was performed for treatment of strictures and fistula. LMWH was stopped after three months. To date the patient is asymptomatic, with normal and patent portal vein detected with periodic US controls.

Bottom Line: Inflammatory bowel diseases are associated with an increased risk of vascular complications.In two of them, hepatic abscess was present.Furthermore, we performed a systematic review based on the clinical literature published on this topic.

View Article: PubMed Central - PubMed

Affiliation: Division of Internal Medicine, DIBIMIS, Ospedali Riuniti Villa Sofia-Vincenzo Cervello, Via Trabucco 180, 90100 Palermo, Italy.

ABSTRACT
Inflammatory bowel diseases are associated with an increased risk of vascular complications. The most important are arterial and venous thromboembolisms, which are considered as specific extraintestinal manifestations of inflammatory bowel diseases. Among venous thromboembolism events, portal vein thrombosis has been described in inflammatory bowel diseases. We report three cases of portal vein thrombosis occurring in patients with active inflammatory bowel disease. In two of them, hepatic abscess was present. Furthermore, we performed a systematic review based on the clinical literature published on this topic.

No MeSH data available.


Related in: MedlinePlus