A case of portal vein thrombus following acute cholangitis

Abstract

A case is 34 years-old male. He was admitted to our hospital complaining of pyrexia and epigastralgia. The finding of blood test showed a rise of hepatocystic enzyme and hyperfibrinolysis. Abdominal CT showed the difference of enhancement of the liver parenchyma between the right lobe and the left lobe. And showed irregular lesion from trunk of portal vein to right branch, the lesion was not enhanced, so we diagnosed portal vein thrombus. The anticoagulant therapy was started. Moreover, the hypertrophy of the gallbladder wall and the wall of a choledoch duct was accepted, we diagnosed acute cholangitis. Since choledocholith was suspected, ERCP was enforced. The calculus was checked and carried out, and we inserted stent into choledochus. Henceforth, the improvement of an inflammation view, hepatocystic enzyme, and a hyperfibrinolysis was accepted. It was thought important for the portal vein thrombosis due to hepatocystic infection to try endoscopic therapy from early stage in addition to thrombolysis and anticoagulant therapy.