Summary
Portal vein thrombosis occurred in a patient who bled from gastric varices that developed after obliteration of esophageal varices by endoscopic sclerotherapy. This complication was recognized only at surgery when thrombectomy and endovenectomy preceded the successful placement of an end-to-side portocaval shunt. At histopathology, the presence of an amorphous, eosinophilic material staining negatively for fibrin and similar to sclerosant injected at sclerotherapy was observed within the clot. This latter finding, previously unreported, provides convincing evidence for the causal relationship of portal vein thrombosis to endoscopic sclerotherapy.
Similar content being viewed by others
References
Reynolds TB: What to do about esophageal varices? N Engl J Med 309:1575–1577, 1983
Korula J: Endoscopic variceal sclerotherapy. J Clin Gastroenterol 10:588–590, 1988
Kage M, Korula J, Harada A, et al: The effects of endoscopic variceal sclerotherapy on the esophagus. A clinical and histopathological study. J Clin Gastroenterol 9:639–643, 1987
Thatcher BS, Sivak MV, Ferguson R, Petras RE: Mesenteric venous thrombosis as a possible complication of endoscopic sclerotherapy. Am J Gastroenterol 81:126–129, 1986
Hunter GC, Steinkirchner T, Burbige EJ, Guernsey JM, Putnam CW: Venous complications of sclerotherapy of esophageal varices. Am J Surg 156:497–501, 1988
Okuda K, Ohnishi K, Kimura K, et al: Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients. Gastroenterology 89:279–286, 1985
Sarfeh IJ: Portal vein thrombosis associated with cirrhosis. Clinical importance. Arch Surg 114:902–905, 1979
Belli L, Sansalone CV, Aseni P, et al: Portal vein thrombosis in cirrhosis. A retrospective analysis. Ann Surg 203:286–291, 1986
Witte CL, Brewer MLO, Witte MH, Pond GB: Protean manifestations of pylethrombosis. A review of thirty-four patients. Ann Surg 202:191–202, 1985
Grobe JL, Kozarek, RA, Sanowski RA, et al: Venography during endoscopic injection sclerotherapy of esophageal varices. Gastrointest Endosc 30:6–8, 1984
McCormack TT, Rose JD, Smith PM, et al: Perforating veins and blood flow in esophageal varices. Lancet 2:1442–1444, 1983
Korula J, Balart LA, Radvan G, et al: A prospective randomized controlled trial of chronic endoscopic sclerotherapy. Hepatology 5:584–589, 1985
Author information
Authors and Affiliations
Additional information
Vol. 36, No. • (••• 1991).
Rights and permissions
About this article
Cite this article
Korula, J., Yellin, A., Kanel, G.C. et al. Portal vein thrombosis complicating endoscopic variceal sclerotherapy. Digest Dis Sci 36, 1164–1167 (1991). https://doi.org/10.1007/BF01297467
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01297467