High Incidence of Hepatitis B Infection-Associated Cirrhosis and Hepatocellular Carcinoma in the Southeast Asian Patients with Portal Vein Thrombosis

Lertpipopmetha, Korn; Auewarakul, Chirayu

doi:10.1186/1471-230x-11-66

Cited by 29 publications

(27 citation statements)

References 42 publications

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“…In a series of 467 patients, thrombosis in several veins has been compared and portal vein thrombosis has been found in 194 (41%) patients. The most common causes of this thrombosis were malignancy in 126 patients (hepatocellular carcinoma, cholangiocellular carcinoma), and infection in 98 patients (hepatitis B, hepatitis C) (11). In the same study, it has been shown that hepatitis C resulted in a higher rate of portal venous thrombosis than hepatitis B (11).…”

Section: Discussionmentioning

confidence: 48%

“…Chronic hepatitis B virus increases coagulation via anticardiolipin antibodies (ACA) and increases thrombosis formation in the portal vein (12). Portal vein thrombosis was observed in 8 out of 11 patients (72%) with hepatitis B-related hepatocellular carcinoma and ACA (+), whereas out of 54 hepatitis B-related hepatocellular carcinoma and ACA (-), portal vein thrombosis was observed in 14 patients (26%) (11). In our case ACA was (-).…”

Section: Discussionmentioning

confidence: 77%

“…The most common causes of this thrombosis were malignancy in 126 patients (hepatocellular carcinoma, cholangiocellular carcinoma), and infection in 98 patients (hepatitis B, hepatitis C) (11). In the same study, it has been shown that hepatitis C resulted in a higher rate of portal venous thrombosis than hepatitis B (11). In that particular study, only one patient was reported to have essential thrombocytosis and portal vein thrombosis (11).…”

Section: Discussionmentioning

confidence: 86%

“…In the same study, it has been shown that hepatitis C resulted in a higher rate of portal venous thrombosis than hepatitis B (11). In that particular study, only one patient was reported to have essential thrombocytosis and portal vein thrombosis (11). This might set an example for the interesting nature of our case.…”

Section: Discussionmentioning

confidence: 86%

“…Hepatitis B virus infection is reported to be associated with portal venous thrombosis in Southeast Asian countries, in hepatic cirrhosis and carcinoma (11). In a series of 467 patients, thrombosis in several veins has been compared and portal vein thrombosis has been found in 194 (41%) patients.…”

Section: Discussionmentioning

confidence: 99%

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A rare cause of acute mesenteric ischemia: JAK2 positivity and chronic active hepatitis B

Baykan

Gündoğan

Yurci

2014

UCD

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Short bowel syndrome occurs as a result of insufficiency in the total length of the small intestine to provide adequate supply of nutrients. Seventy-five percent of cases are due to massive intestinal resection. A 35-year-old male complaining of abdominal pain was admitted to the gastroenterology department. A CT scan was performed, showing total occlusion of the portal vein and superior mesenteric vein. During the operation, widespread edema and necrosis of the small intestine were found. The necrotic segments of the small intestine were resected. The spleen was larger than normal and, in some parts, infarcts were evident, thus asplenectomy was also performed during surgery. A second-look procedure was performed 24 hours later, and an additional 10 cm jejunal resection and anastomosis was performed. His further evaluations revealed myeloproliferative disease and chronic active hepatitis B leading to thrombosis. Essential thrombocytosis and portal vein thrombosis are common in hepatitis B infection. Patients with complaints of abdominal pain in the context of essential thrombocytosis and hepatitis B should be handled with caution as they are at risk of developing portal vein thrombosis.Key Words: Portal vein thrombosis, myeloproliferative disease, hepatitis B INTRODUCTIONShort bowel syndrome results from the inability of the total length of the small intestine to provide adequate nutritional support. Seventy-five percent of cases are caused by massive intestinal resection (1). In adults, mesenteric occlusion, midgut volvulus and traumatic avulsion of superior mesenteric veins are the most common causes (1). In this article, an atypical short bowel syndrome resulting from portal vein thrombosis that occurred in a patient with JAK 2 positivity and chronic active hepatitis B, will be presented. CASE PRESENTATIONA 35-year old male patient complaining of abdominal pain was admitted to the gastroenterology clinic. After obtaining informed consent from the patient examinations were started. The WBC: 8.87x10 3 / μL, hemoglobin 14 g/dL, and platelet were 626x10 3 /μL. The abdominal ultrasonography revealed splenomegaly and portal vein thrombosis, and the upper gastrointestinal endoscopy identified prominent esophageal submucosal veins. The abdominal computed tomography showed complete occlusion of the portal and superior mesenteric veins and splenomegaly ( Figure 1). Due to aggravation of the patient's abdominal pain and increasing white blood cell count (22x10 3 /μL) an emergency operation was decided. During the operation, generalized edema and necrosis in the small bowel loops, from 55 cm. distal to the ligament of Treitz up to 35 cm proximal to the ileocecal valve was identified ( Figure 1). The necrotic bowel segment was resected. The spleen was larger than normal and contained areas of infarction, thus splenectomy was performed. Since there were concerns regarding the viability of the remaining small intestine, a second-look operation was planned and the patient was transferred to the General Surgery Intensive Care...

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 77%