Case report: diagnosis of portal vein thrombosis with successful treatment and subsequent 3-year follow-up

Yu.M. Stepanov, S.V. Kosynska

Abstract


The article deals with the clinical observation of extrahepatic portal hypertension as an outcome of portal vein thrombosis, which was first manifested by hemorrhage from varicose veins of the esophagus and stomach, in a young patient. Features of an anamnesis, a clinical picture pointed to the asymptomatic course of the disease until the moment of the catastrophe. The complexity of these patients is caused by the lack of informative routine methods of study, the need for special research methods for the diagnosis and non-standard methods of treatment. The data of laboratory-instrumental methods of study in this patient are analyzed, a modern diagnostic search for the causes of liver disease and portal hypertension syndrome in real conditions is presented. The absence of signs of hepatitis was revealed, and the evaluation of the liver with elastometry excluded the presence of fibrosis in this patient. The diagnosis of extrahepatic portal hypertension is made, and the patient is directed to surgical treatment. A successful shunt operation was performed at the Institute of Surgery and Transplantology. Further, a positive dynamics of clinical data, splenomegaly has been shown, which caused pain syndrome and hypersplenism. The conservative treatment of the syndrome of portal hypertension and symptomatic treatment of the patient are described. The necessity of an individual choice of motion regimen and drug management with inclusion of ursodeoxycholic acid is proved. For 3 years, the patient has a significant reduction in portal hypertension, with the preservation of the parenchyma of the liver, which gives hope for positive long-term results.


Keywords


portal vein thrombosis; extrahepatic portal hypertension; liver elastometry; treatment outcomes



DOI: https://doi.org/10.22141/2308-2097.51.1.2017.97877

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