TWO CASES OF PORTAL VEIN THROMBOSIS AS A COMPLICATION OF ENDOSCOPIC INJECTION SCLEROTHERAPY FOR ESOPHAGEAL VARICES

Abstract

Two cases of portal and mesenteric venous thrombosis with bowel infarction occurring after endoscopic injection sclerotherapy (EIS) for esophageal varices are reported. Case 1 was a 62-year-old female. She was undergone prophylactic EIS in August, 1985. Six months later, a small thrombosis attached to the portal vein wall was detected by abdominal computed tomography and ultrasonography. Second EIS for reccurent esophageal varices was performed in April, 1988. One week later, she complained of colicky abdominal pain. A plain roentogenography of abdomen revealed a dilated and edematous small bowel consistent with ischemic colitis. Her condition became worse and died three weeks after second EIS. A case with autopsy findings demonstrated old and fresh thrombosis in the portal vein and superior mesenteric vein with hemorrhagic infarct of the small intestine. Case 2 was a 60-year-old male. He was carried out elective EIS in December, 1987. One year and six months after, he complained severe abdominal pain followed diarrhea and fever. A plain roentogenography of abdomen revealed areas of dilated small bowel consistent with ileus. He died two weeks after he was treated for his intestinal obstruction. Autopsy findings showed fresh thrombosis of portal and mesenteric vein, and secondary infarction of small bowel was noted. It was suggested that both cases of portal and mesenteric venous thrombosis were referred to the change of blood flow after EIS.