Deep venous thrombosis (DVT) of the upper extremity has been recently been recognized as being more common than previously reported (probably because of the increasingly frequent use of subclavian venous access). Since the initial descriptions of axillary-subclavian vein thrombosis more than 100 years ago, studies cites a 1.3% to 2.1% incidence of all DVT that occurs in the axillary or subclavian veins. Axillary-subclavian vein thrombosis is commonly associated with significant morbidity. The most serious aspect of morbidity and mortality is pulmonary embolization. Venography or digital subtraction studies are most reliable in allowing detection of thrombosis and Duplex imaging of vein is useful in following the course and assessing the effect of treatment. Early diagnosis and initiation of treatment before thrombus organization are important for successful outcome. Polycythemia vera are at an especially high risk for both thrombotic and hemorrhghic events and postoperative complications. We report a case of axillary-subclavian vein thrombosis after left subclavian vein catheterization in polycythemia vera.
Catheterization* ; Catheters* ; Early Diagnosis ; Incidence ; Mortality ; Phlebography ; Polycythemia Vera* ; Polycythemia* ; Postoperative Complications ; Subclavian Vein* ; Thrombosis* ; Upper Extremity ; Veins* ; Venous Thrombosis

Portal vein thrombosis (PVT) is an uncommon cause of presinusoidal portal hypertension. Among various hepatoportal disorders, noncirrhotic portal hypertension conditions such as idiopathic portal hypertension (IPH) are considered to have a close relation with PVT. PVT is known to have several predisposing conditions, including infection, malignancies, and coagulation disorders. There is growing interest and recognition that deficiencies in proteins C and S are associated with a hypercoagulable state. These deficiencies are regarded as key factors of systemic hypercoagulability and recurrent venous thromboembolism. We report the case of a 19-year-old male diagnosed as IPH with PVT and combined deficiencies in proteins C and S.
Humans ; Hypertension, Portal/complications/*diagnosis/pathology ; Male ; *Portal Vein ; Protein C Deficiency/*complications ; Protein S Deficiency/*complications ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis/pathology ; Young Adult

Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year-old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.
Acute Disease ; Humans ; Male ; *Mesenteric Veins ; Middle Aged ; Pancreatitis/complications/*diagnosis ; Tomography, X-Ray Computed ; Venous Thrombosis/*diagnosis/etiology/radiography

Portal vein thrombosis is a rare complication accompanied with acute pancreatitis or cholangitis/cholecystitis. The main pathogenesis of portal vein thrombosis in pancreatitis or cholangitis/cholecystitis are suggested to be venous compression by pseudocyst and an imbalance between the blood coagulation and fibrinolysis. In this case report, we experienced a 63 year old male who developed portal vein thrombosis later in the course of the treatment of acute gallstone pancreatitis with cholangitis/cholecystitis without any symptom or sign. The diagnosis of portal vein thrombosis was given on follow up CT scan and serum protein S activity was decreased to 27% in laboratory study. Immediate anticoagulation therapy with heparin and thrombolytic therapy with urokinase and balloon dilatation were performed. Despite the aggressive treatment, complete reperfusion could not be obtained. With oral warfarin anticoagulation, the patient showed no disease progression and was discharged. We report a case of portal vein thrombosis as a complication of acute pancreatitis and cholangitis/cholecystitis with a review of literatures.
Acute Disease ; Cholangitis/*complications/diagnosis ; Cholecystitis/complications ; Humans ; Male ; Middle Aged ; Pancreatitis/*complications/diagnosis ; *Portal Vein ; Tomography, X-Ray Computed ; Venous Thrombosis/diagnosis/*etiology

Adult ; Humans ; Intracranial Thrombosis ; diagnosis ; drug therapy ; etiology ; Male ; Methylprednisolone ; therapeutic use ; Nephrotic Syndrome ; complications ; drug therapy ; Venous Thrombosis ; diagnosis ; drug therapy ; etiology

in the leg and the toe and was treated with angioplasty and thrombolytic therapy with phlebotomy.
Female ; Humans ; Middle Aged ; Polycythemia Vera/complications/*diagnosis/ultrasonography ; Portal Vein/*abnormalities ; Tomography, X-Ray Computed ; Venous Thrombosis/etiology

OBJECTIVETo analyze the clinical characteristics diagnosis and treatment of patients with mesenteric venous thrombosis early after operation.

METHODSA retrospective study was performed on the clinical data of 7 patients with mesenteric venous thrombosis early after operation from 1990 to 2004.

RESULTSPatients had main clinical manifestations of severe abdominal pain and vomiting, but abdominal signs were slight. The systemic toxic symptoms occurred in 2 cases at late course. The examination of abdominal X- ray showed intestinal obstruction of all patients. Four patients received abdominal CT- scanning, of whom 3 patients were diagnosed as mesenteric venous thrombosis. Seven patients received exploratory operation. The necrotic intestinal segments were resected. Two patients had short intestinal syndromes after operation, one of them died of serious malnutrition. Four patients who had recurrence of portal, mesenteric and iliac venous thrombosis needed a long-term therapy of warfarin and aspirin after discharge.

CONCLUSIONIt is easy to make a mistake in diagnosis because of the lacking of characteristic clinical manifestations. Exploratory operation immediately plus anticoagulant therapy is strongly recommended.

Adult ; Female ; Humans ; Male ; Mesenteric Vascular Occlusion ; diagnosis ; drug therapy ; etiology ; Middle Aged ; Postoperative Complications ; diagnosis ; drug therapy ; Retrospective Studies ; Thrombolytic Therapy ; Venous Thrombosis ; diagnosis ; drug therapy ; etiology

OBJECTIVETo investigate and summarize the experience in clinical presentation, diagnosis and treatment of portal vein thrombosis after orthotopic liver transplantation (OLT).

METHODSThe clinical data of 402 patients who underwent OLT from January 2003 to February 2007 were reviewed. A retrospective study was performed on etiology, prognosis and treatment in 9 cases of portal vein thrombosis after OLT.

RESULTSAll of the 9 cases received anticoagulant and antiaggregation therapy, within whom one underwent percutaneous transluminal angioplasty and stent placement, one underwent retransplantation after failure of thrombolysis therapy, and one received surgical embolectomy. Six patients died of multiple organ failure on 9th, 30th, 34th, 40th, 48th, 6 2nd days, respectively, while 3 patients survived.

CONCLUSIONSThe major risk factors of portal vein thrombosis after OLT were pathological changes in portal vein, abnormal blood stream dynamics, hypercoagulable status and improper surgical technique. Prophylactic intervention to patients with high risk factors, early diagnosis and aggressive comprehensive therapy on portal vein thrombosis patients are essential to improve prognosis.

Adult ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Portal Vein ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Prognosis ; Retrospective Studies ; Venous Thrombosis ; diagnosis ; etiology ; therapy

Mesenteric venous thrombosis is a clinically very rare disease, and may cause bowel infarction and gangrene. Difficulty in the dignosis the disease due to its non-specific symptoms and low prevalence can cause a clinically fatal situation. Mesenteric venous thrombosis may be caused by both congenital and acquired factors, and protein C deficiency, which is a very rare genetic disorder, is one of many causes of mesenteric thrombosis. The authors experienced a case of mesenteric venous thrombosis caused by protein C deficiency in a patient with duodenal ulcer bleeding, so here we report a case together with literature review.
Duodenal Ulcer/*complications/diagnosis ; Endoscopy, Gastrointestinal ; Humans ; Male ; *Mesenteric Veins ; Middle Aged ; Peptic Ulcer Hemorrhage/*complications ; Protein C Deficiency/*complications/diagnosis ; Tomography, X-Ray Computed ; Venous Thrombosis/*diagnosis/etiology/ultrasonography

Portal vein invasion is a grave prognostic indicator in the setting of hepatocellular carcinoma (HCC). There is currently no effective method for preventing the invasion of HCC into the main portal vein. We report here a case of advanced HCC with portal vein tumor thrombosis that was effectively treated with percutaneous ethanol injection (PEI), having previously enabled subsequent successive transarterial chemoembolization (TACE). A 60-year-old male patient was diagnosed with a huge HCC, based on computed tomography and angiographic findings. Despite two sessions of TACE, the tumor invaded the right portal vein. PEI was performed on the malignant portal vein thrombosis, and three sessions thereof reduced the extent of tumor thrombi in the portal vein. Successive TACEs were performed to treat the HCC in the hepatic parenchyma. The patient was still living 19 months after the first PEI with no evidence of tumor recurrence, and his liver function remained well preserved.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Chemoembolization, Therapeutic ; Ethanol/*administration & dosage ; Humans ; Injections, Intralesional ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; *Portal Vein/pathology ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/diagnosis/*therapy