Management of acute extensive portal vein thrombosis: the complexity and morbidity

A 62-year-old patient was admitted with an acute unprovoked portal vein thrombosis with splenic and mesenteric extension. His progress was complicated by progressive small bowel ischaemia and increasing clot burden despite systemic anticoagulation. This case report describes the use of catheter-directed thrombolysis via a transjugular intrahepatic portosystemic shunt, with the disease and its treatment complicated by a ruptured iatrogenic pseudoaneurysm, abdominal compartment syndrome and small bowel infarction necessitating extensive small bowel resection.

Superior Mesenteric venous thrombosis in a patient with protein C deficiency

Mesenteric venous thrombosis causing small-bowel infarction is an extremely rare cause of acute abdomen and often difficult to diagnose. Both congenital and acquired causes are responsible. Protein C deficiency is a rare genetic abnormality that predisposes the patient to thrombophilia and leads to thrombosis, often at unusual sites. It mimics clinically with many differentials.1 This paper presents a case of superior mesenteric venous thrombosis caused by protein C deficiency, which is a rare disease. A 68-year-old foreigner female presented with complaints of constant, diffuse abdominal pain of 7 days associated with nausea, vomiting, and anorexia. Even with all sorts of conservative management, pain was not subsiding. Contrasted computed tomography of the abdomen revealed SMV thrombosis. Immediate anticoagulant was started & hypercoagulability workup revealed protein C deficiency. It is concluded that the mesenteric venous thrombosis might be caused by underlying protein C deficiency, while protein S and antithrombin III levels were normal.Bangladesh Crit Care J March 2018; 6(1): 50-53

Gastrointestinal pathology

This chapter discusses gastrointestinal pathology, including gastrointestinal malformations, oesophagitis, oesophageal polyps and nodules, oesophageal carcinoma, gastritis, gastric polyps, gastric carcinoma, gastrointestinal stromal tumours, peptic duodenitis, coeliac disease, small bowel infarction, intestinal infections, intestinal obstruction, acute appendicitis, Crohn’s disease, ulcerative colitis, colorectal polyps, colorectal carcinoma, diverticular disease, and anal pathology.