Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt

Manabu Hayashi; Tatsuro Sugaya; Masashi Fujita; Jun Nakamura; Hiromichi Imaizumi; Kazumichi Abe; Atsushi Takahashi; Tadayuki Takagi; Takuto Hikichi; Hiromasa Ohira

doi:10.2169/internalmedicine.4925-20

This article has now been updated. Please use the final version.

Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt

Manabu Hayashi, Tatsuro Sugaya, Masashi Fujita, Jun Nakamura, Hiromichi Imaizumi, Kazumichi Abe, Atsushi Takahashi, Tadayuki Takagi, Takuto Hikichi, Hiromasa Ohira

Author information

Manabu Hayashi
Department of Gastroenterology, Fukushima Medical University, Japan
Tatsuro Sugaya
Department of Gastroenterology, Fukushima Medical University, Japan
Masashi Fujita
Department of Gastroenterology, Fukushima Medical University, Japan
Jun Nakamura
Department of Gastroenterology, Fukushima Medical University, Japan
Department of Endoscopy, Fukushima Medical University Hospital, Japan
Hiromichi Imaizumi
Department of Gastroenterology, Fukushima Medical University, Japan
Department of Internal Medicine, Iwase General Hospital, Japan
Kazumichi Abe
Department of Gastroenterology, Fukushima Medical University, Japan
Atsushi Takahashi
Department of Gastroenterology, Fukushima Medical University, Japan
Tadayuki Takagi
Department of Gastroenterology, Fukushima Medical University, Japan
Takuto Hikichi
Department of Endoscopy, Fukushima Medical University Hospital, Japan
Hiromasa Ohira
Department of Gastroenterology, Fukushima Medical University, Japan

Keywords: Congenital portosystemic shunt, portal vein thrombosis, ectopic varices, danaparoid

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4925-20

DOI https://doi.org/10.2169/internalmedicine.4925-20

The final version of this article is now available: Vol. 59 (2020), No. 21 pp. 2705-2710

Details

Abstract

A 33-year-old man presented with hepatic encephalopathy and was diagnosed to have a noncirrhotic extrahepatic portosystemic shunt (NCPSS). He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left internal iliac vein, including the NCPSS, and varices of the sigmoid colon. Thrombosis was treated with danaparoid sodium and antithrombin III followed by edoxaban. After treatment, the thrombosis disappeared from the intrahepatic portal vein, but it remained in the NCPSS. The sigmoid colon varices were followed up without any treatment. Follow-up is needed in NCPSS patients in order to make an early detection of complications.

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