Журнал клинических случаев

Surgical Thrombectomy for Complete Portal Vein Thrombosis Induced by Blunt Abdominal Trauma

Abstract

Ondrej Maly, Filip Cecka, Petr Dulicek and Jiri Paral

Background: Blunt abdominal injury is a known, but very rare cause of portal vein thrombosis. In most cases, full anticoagulant therapy is sufficient. Surgical thrombectomy is an extremely rare procedure in the treatment of acute portal thrombosis.
Materials and Methods: We present a case of a young patient with portal vein thrombosis and its branches after a blunt abdominal injury resulting from the sport. Due to severe infarction of the intestinal loops, we chose surgical thrombectomy as the only causal treatment option. This procedure is generally rarely reported in the scientific literature. However, it has not yet been described with a blunt abdominal injury. The patient was subsequently shown to have a Leiden mutation in a heterozygous form. The interplay of all factors including blunt abdominal injury, Leiden mutation, and intestinal malrotation could lead to acute thrombosis of the portal vein and its branches.
Conclusions: We successfully used direct surgical thrombectomy from portal vein and its branches for the patient with portal vein thrombosis and severe small intestine infarction after a blunt abdominal trauma as the only available treatment option, because other treatment options were not suitable in this patient. In our case, early diagnosis, right decision to choose surgical treatment, and direct surgical trombectomy resulted in success and the patient has fully returned to normal life.