Portal Vein Thrombosis After Laparoscopic Colectomy: Thrombolytic Therapy via the Superior Mesenteric Vein

Poultsides, George A.; Lewis, W. Cannon; Feld, Robert; Walters, David L.; Cherry, David A.; Ruby, Steven T.
October 2005
American Surgeon;Oct2005, Vol. 71 Issue 10, p856
Academic Journal
Portal vein thrombosis is a rare but well-reported complication after laparoscopic surgery. We present a case of portomesenteric venous thrombosis that occurred 8 days after a laparoscopic-assisted right hemicolectomy. Systemic anticoagulation failed to improve symptoms. The early postoperative state precluded the use of transarterial thrombolytic therapy. Transjugular intrahepatic catheter-directed infusion of urokinase into the superior mesenteric vein resulted in clearance of thrombus and resolution of symptoms. The published data on laparoscopy-induced splanchnic venous thrombosis and transjugular intrahepatic intramesenteric thrombolysis are discussed.


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