Splanchnic vein thrombosis in a young patient with congenital antithrombin III deficiency treated with segmental resection of small bowel and thrombectomy of portal vein thrombus

Splanchnic vein thrombosis in a young patient with congenital antithrombin III deficiency treated with segmental resection of small bowel and thrombectomy of portal vein thrombus

A 42-year-old man, who was previously healthy, presented with progressive abdominal pain for five days. Portal vein, main portal vein, splenic vein and proximal superior mesenteric vein thromboses were observed on computed tomography scan. Antithrombin III deficiency was found following an extensive workup for hypercoagulable state. Anticoagulation therapy was immediately administered with low-molecular weight heparin and coumadin. Repeated computed tomography scan showed small intestinal wall thickening, ascites and progressive portal vein thrombosis. Emergency laparotomy was performed with small bowel segmental resection and thrombectomy of portal vein thrombosis.