Portal Vein Thrombosis As A Complication After Splenectomy In Cirrhosis: A Case Study

Portal thrombosis is one of rare complication after splenectomy and porta-azygous devascularization, being reported with the incidence of 0.2%-10%. Diagnosis and therapy may be difficult due to various clinic presentation. We reported a case of upper-gastrointestinal bleeding with cirrhosis after splenectomy in a 42-year-old man. After the treatment of somatostatin analogue, propranolol and thrombin, the portal pressure was reduced and bleeding was arrested. He had diffuse abdominal pain and high fever during hospitalization,The abdominal B ultrasonography revealed portal thrombosis. The patient was treated with thrombolytic (urokinase and low molecular heparin) for 14 days, and anticoagulation for 4 months and ultimately thrombus appeared again.In the thesis we analysed the etiologic factors includinghematological hypercoagulable states, activated protein C resistance, or(and) abnormal protein S molecule, and states two kinds of thrombolytic therapies( drugs and specific usages) and their features, and elaborated the affecting factors of poorly therapeutic result :whether combined whole and local thrombolytic therapy or not, when to begin thrombolytic treatment, which examination selected to cease thrombolytic, whether arrested bleeding before thrombosis.