Portal vein thrombosis and pulmonary artery thromboembolism after laparoscopic colectomy

Portal vein thrombosis is a very severe and lethal complication, and rarely occurs after operations for colorectal cancer. We report a case of portal vein thrombosis after laparoscopic surgery for rectal cancer. A 72-year-old man underwent a low anterior resection for an advanced rectal cancer. Since he had a slight fever on postoperative day 7, he underwent an abdominal contrast enhanced computed tomography scan and he was diagnosed with a portal vein thrombosis. There was no evidence of congestion of the small intestine or liver necrosis. Anticoagulation therapy was started immediately, and the thrombus disappeared on postoperative day 14. This disease was caused by several reasons, such as decreased portal vein flow resulting from increased abodominal pressure and operative position, a hypercoagulable state from having a malignant tumor, and dehydration during the perioperative period. Key words：portal vein thrombosis，rectal cancer，laparoscopic surgery

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A Case of Pulmonary Artery Thrombosis and Portal Vein Thrombosis Developed after Laparoscopy-assisted Low Anterior Resection

Niwa

Sekino

Murase

et al. 2015

Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc)

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A 61-year-old man was referred to our hospital because of anal bleeding. Colonoscopy revealed a type 1 tumor at the rectum Ra. Biopsy of the tumor revealed a diagnosis of well to moderately differentiated adenocarcinoma. Laparoscopy-assisted low anterior resection was performed with the diagnosis of rectal cancer. The operating time was 4 hours and one minute, and the operative bleeding amounted to 25 ml. The postoperative course was uneventful, but abdominal pain and an increase in inflammatory reaction occurred on the sixth postoperative day. From CT findings, we diagnosed the case as pulmonary artery thrombosis due to a thrombus of the right internal iliac vein and portal vein thrombosis due to a thrombus of the inferior mesenteric vein. Apparent abnormalities in the coagulation system were absent. Anticoagulant therapy was started and symptomatic remission and shrinkage of the thrombi on imaging were gained. The patient was thus discharged from our hospital on the 24 th postoperative day. Since clinical cases of simultaneous occurrence of pulmonary artery thrombosis and portal vein thrombosis are quite rare, we here present our case together with a review of the literature.

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Portal vein thrombosis and pulmonary artery thromboembolism after laparoscopic colectomy

Cited by 3 publications

References 21 publications

A Case of Portal Vein Thrombosis after Laparoscopic Colectomy for Sigmoid Colon Cancer with Liver Metastasis

A Case of Portal Vein Thrombosis after Laparoscopic Colectomy for Sigmoid Colon Cancer with Liver Metastasis

A Case of Portal Vein Thrombosis after Laparoscopic Surgery for Rectal Cancer

A Case of Pulmonary Artery Thrombosis and Portal Vein Thrombosis Developed after Laparoscopy-assisted Low Anterior Resection

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