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Portal vein thrombosis after total knee replacement: a case report
Guy Martin1, Abbas Rashid, Hani B Abdul-Jabar
1Department of Trauma and Orthopaedics, Northwick Park Hospital, Middlesex, Harrow, United Kingdom.
Journal of Orthopaedic Surgery (Hong Kong)
|August 31, 2012
Summary
A 74-year-old woman developed portal vein thrombosis after knee replacement surgery. Early detection and treatment with low-molecular-weight heparin led to full recovery, highlighting the condition
Area of Science:
- Vascular Surgery
- Hepatology
- Cardiology
Background:
- A 74-year-old female patient with a history of atrial fibrillation on warfarin anticoagulation underwent elective total knee replacement.
- Warfarin was discontinued 7 days pre-surgery and replaced with prophylactic low-molecular-weight heparin (LMWH).
Observation:
- Postoperative day 1, routine blood tests indicated impaired hepatic synthetic function.
- Doppler ultrasonography confirmed the presence of portal vein thrombosis (PVT).
Findings:
- Despite standard anticoagulation, the patient developed PVT, a rare but serious complication.
- Treatment with therapeutic LMWH doses normalized liver function within 2 weeks.
Implications:
- Portal vein thrombosis is a potentially fatal condition.
- Early diagnosis and prompt anticoagulation therapy can reverse PVT and improve patient outcomes.
- This case underscores the importance of vigilant monitoring for PVT in patients with risk factors undergoing surgery.
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