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Hepatic infarction with portal thrombosis
K Yamashita1, H Tsukuda, Y Mizukami
1Department of Internal Medicine (Section 1), Sapporo Medical University School of Medicine, Japan.
Journal of Gastroenterology
|November 14, 1997
Summary
A patient with liver cirrhosis developed portal vein thrombosis and hepatic infarction after treatment for esophageal varices. This case highlights potential complications and risk factors, including chronic pancreatitis.
Area of Science:
- Gastroenterology and Hepatology
- Vascular Medicine
Background:
- Esophageal varices are a common complication of liver cirrhosis.
- Treatment options for esophageal varices include endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS).
- Portal vein thrombosis (PVT) is a serious condition that can lead to hepatic infarction.
Observation:
- A 63-year-old woman with liver cirrhosis and esophageal varices underwent EVL and EIS.
- Two months post-procedure, she presented with abdominal pain and elevated liver enzymes.
- Imaging revealed multiple hepatic lesions, consistent with hepatic infarction.
Findings:
- Autopsy confirmed splenic and portal vein thrombosis, multiple hepatic infarctions, and chronic pancreatitis.
- Liver cirrhosis and chronic pancreatitis were identified as risk factors for PVT.
- Esophageal variceal treatment was suspected as a trigger for PVT.
Implications:
- This case underscores the potential risk of PVT and hepatic infarction following endoscopic treatment for esophageal varices in cirrhotic patients.
- Identifying and managing risk factors like chronic pancreatitis is crucial.
- Further research may be needed to elucidate the precise mechanisms linking variceal treatment to thrombosis.