Portal and mesenteric venous thrombosis as a complication of endoscopic sclerotherapy

We report on the occurrence of portal and mesenteric venous thrombosis in two patients who underwent endoscopic injection sclerotherapy (EIS) for bleeding esophageal varices. One patient was diagnosed at autopsy, and portal and mesenteric venous thrombosis was not suspected during life. The second patient was suspected on ultrasound examination and was diagnosed by angiography. In the second case, therapy was effective and symptoms disappeared. He was treated by a distal splenorenal shunt after he had stabilized for 1 month. During the operation, no evidence of mesenteric infarction was found. The venous phase of the superior mesenteric arteriogram 1 month after surgery revealed an organized thrombosis in the right intrahepatic portal branches. No other thrombi were seen. This patient is the first reported who has survived portal and mesenteric venous thrombosis after sclerotherapy.