Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt
A 33-year-old man presented with hepatic encephalopathy and was diagnosed to have a noncirrhotic extrahepatic portosystemic shunt (NCPSS). He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left i...
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| Veröffentlicht in: | Internal Medicine 2020/11/01, Vol.59(21), pp.2705-2710 |
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| creator | Hayashi, Manabu Sugaya, Tatsuro Fujita, Masashi Nakamura, Jun Imaizumi, Hiromichi Abe, Kazumichi Takahashi, Atsushi Takagi, Tadayuki Hikichi, Takuto Ohira, Hiromasa |
| description | A 33-year-old man presented with hepatic encephalopathy and was diagnosed to have a noncirrhotic extrahepatic portosystemic shunt (NCPSS). He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left internal iliac vein, including the NCPSS, and varices of the sigmoid colon. Thrombosis was treated with danaparoid sodium and antithrombin III followed by edoxaban. After treatment, the thrombosis disappeared from the intrahepatic portal vein, but it remained in the NCPSS. The sigmoid colon varices were followed up without any treatment. Follow-up is needed in NCPSS patients in order to make an early detection of complications. |
| doi_str_mv | 10.2169/internalmedicine.4925-20 |
| format | Article |
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He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left internal iliac vein, including the NCPSS, and varices of the sigmoid colon. Thrombosis was treated with danaparoid sodium and antithrombin III followed by edoxaban. After treatment, the thrombosis disappeared from the intrahepatic portal vein, but it remained in the NCPSS. The sigmoid colon varices were followed up without any treatment. Follow-up is needed in NCPSS patients in order to make an early detection of complications.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.4925-20</identifier><identifier>PMID: 32669497</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Adult ; Anticoagulants - therapeutic use ; Antithrombin ; Case Report ; Chondroitin Sulfates - therapeutic use ; Colon ; Colon, Sigmoid - physiopathology ; Computed tomography ; congenital portosystemic shunt ; danaparoid ; Dermatan Sulfate - therapeutic use ; ectopic varices ; Factor Xa Inhibitors - therapeutic use ; Heparitin Sulfate - therapeutic use ; Hepatic encephalopathy ; Hepatic Encephalopathy - diagnosis ; Hepatic Encephalopathy - surgery ; Humans ; Internal medicine ; Male ; Portal vein ; Portal Vein - physiopathology ; Portal Vein - surgery ; portal vein thrombosis ; Portasystemic Shunt, Transjugular Intrahepatic - adverse effects ; Pyridines - therapeutic use ; Thiazoles - therapeutic use ; Thrombosis ; Thrombosis - complications ; Thrombosis - drug therapy ; Treatment Outcome ; Varicose Veins - etiology ; Varicose Veins - physiopathology ; Varicose Veins - therapy</subject><ispartof>Internal Medicine, 2020/11/01, Vol.59(21), pp.2705-2710</ispartof><rights>2020 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2020</rights><rights>Copyright © 2020 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c667t-d3b83ea4b97485db833df9a19c5bd1c5bca8b861d2ff7aef4ecc9f6a79ba67fa3</citedby><cites>FETCH-LOGICAL-c667t-d3b83ea4b97485db833df9a19c5bd1c5bca8b861d2ff7aef4ecc9f6a79ba67fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691034/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691034/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1881,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32669497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hayashi, Manabu</creatorcontrib><creatorcontrib>Sugaya, Tatsuro</creatorcontrib><creatorcontrib>Fujita, Masashi</creatorcontrib><creatorcontrib>Nakamura, Jun</creatorcontrib><creatorcontrib>Imaizumi, Hiromichi</creatorcontrib><creatorcontrib>Abe, Kazumichi</creatorcontrib><creatorcontrib>Takahashi, Atsushi</creatorcontrib><creatorcontrib>Takagi, Tadayuki</creatorcontrib><creatorcontrib>Hikichi, Takuto</creatorcontrib><creatorcontrib>Ohira, Hiromasa</creatorcontrib><title>Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 33-year-old man presented with hepatic encephalopathy and was diagnosed to have a noncirrhotic extrahepatic portosystemic shunt (NCPSS). He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left internal iliac vein, including the NCPSS, and varices of the sigmoid colon. Thrombosis was treated with danaparoid sodium and antithrombin III followed by edoxaban. After treatment, the thrombosis disappeared from the intrahepatic portal vein, but it remained in the NCPSS. The sigmoid colon varices were followed up without any treatment. Follow-up is needed in NCPSS patients in order to make an early detection of complications.</description><subject>Adult</subject><subject>Anticoagulants - therapeutic use</subject><subject>Antithrombin</subject><subject>Case Report</subject><subject>Chondroitin Sulfates - therapeutic use</subject><subject>Colon</subject><subject>Colon, Sigmoid - physiopathology</subject><subject>Computed tomography</subject><subject>congenital portosystemic shunt</subject><subject>danaparoid</subject><subject>Dermatan Sulfate - therapeutic use</subject><subject>ectopic varices</subject><subject>Factor Xa Inhibitors - therapeutic use</subject><subject>Heparitin Sulfate - therapeutic use</subject><subject>Hepatic encephalopathy</subject><subject>Hepatic Encephalopathy - diagnosis</subject><subject>Hepatic Encephalopathy - surgery</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Portal vein</subject><subject>Portal Vein - physiopathology</subject><subject>Portal Vein - surgery</subject><subject>portal vein thrombosis</subject><subject>Portasystemic Shunt, Transjugular Intrahepatic - adverse effects</subject><subject>Pyridines - therapeutic use</subject><subject>Thiazoles - therapeutic use</subject><subject>Thrombosis</subject><subject>Thrombosis - complications</subject><subject>Thrombosis - drug therapy</subject><subject>Treatment Outcome</subject><subject>Varicose Veins - etiology</subject><subject>Varicose Veins - physiopathology</subject><subject>Varicose Veins - therapy</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkUFv1DAQhS0EokvhLyBLXLikJLZjxxcktGoBqaWVWrhajjPZeJXYi-1U9N_jaJcVbS_PGvmbN2M_hHBVnpGKy0_WJQhOjxN01lgHZ0ySuiDlC7SqKJOFILR-iValrJqCZDlBb2LcliVthCSv0QklnEsmxQq1t3YzedvhtR-9w790sAYi7mbAyeMrHaO9B3w3BD-1PtqIfY81_uGdsSEMPlmDz_-koAfY6aW48SH5-BATTLm6HWaX3qJXvR4jvDucp-jnxfnd-ltxef31-_rLZWE4F6noaNtQ0KyVgjV1lwva9VJX0tRtV2UxumkbXnWk74WGnoExsudayFZz0Wt6ij7vfXdzmz_GgMt7jWoX7KTDg_Laqsc3zg5q4--V4LIqKcsGHw8Gwf-eISY12WhgHLUDP0dFGGGM1ayuM_rhCbr185LIQtWC8JI1i2Gzp0zwMQboj8tUpVqCVE-DVEuQipS59f3_jzk2_ksuA9d7YBuT3sAR0CHHMMJz51rmkYseRhxJM-igwNG_LlrANQ</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Hayashi, Manabu</creator><creator>Sugaya, Tatsuro</creator><creator>Fujita, Masashi</creator><creator>Nakamura, Jun</creator><creator>Imaizumi, Hiromichi</creator><creator>Abe, Kazumichi</creator><creator>Takahashi, Atsushi</creator><creator>Takagi, Tadayuki</creator><creator>Hikichi, Takuto</creator><creator>Ohira, Hiromasa</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201101</creationdate><title>Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt</title><author>Hayashi, Manabu ; Sugaya, Tatsuro ; Fujita, Masashi ; Nakamura, Jun ; Imaizumi, Hiromichi ; Abe, Kazumichi ; Takahashi, Atsushi ; Takagi, Tadayuki ; Hikichi, Takuto ; Ohira, Hiromasa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c667t-d3b83ea4b97485db833df9a19c5bd1c5bca8b861d2ff7aef4ecc9f6a79ba67fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Anticoagulants - therapeutic use</topic><topic>Antithrombin</topic><topic>Case Report</topic><topic>Chondroitin Sulfates - therapeutic use</topic><topic>Colon</topic><topic>Colon, Sigmoid - physiopathology</topic><topic>Computed tomography</topic><topic>congenital portosystemic shunt</topic><topic>danaparoid</topic><topic>Dermatan Sulfate - therapeutic use</topic><topic>ectopic varices</topic><topic>Factor Xa Inhibitors - therapeutic use</topic><topic>Heparitin Sulfate - therapeutic use</topic><topic>Hepatic encephalopathy</topic><topic>Hepatic Encephalopathy - diagnosis</topic><topic>Hepatic Encephalopathy - surgery</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Male</topic><topic>Portal vein</topic><topic>Portal Vein - physiopathology</topic><topic>Portal Vein - surgery</topic><topic>portal vein thrombosis</topic><topic>Portasystemic Shunt, Transjugular Intrahepatic - adverse effects</topic><topic>Pyridines - therapeutic use</topic><topic>Thiazoles - therapeutic use</topic><topic>Thrombosis</topic><topic>Thrombosis - complications</topic><topic>Thrombosis - drug therapy</topic><topic>Treatment Outcome</topic><topic>Varicose Veins - etiology</topic><topic>Varicose Veins - physiopathology</topic><topic>Varicose Veins - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hayashi, Manabu</creatorcontrib><creatorcontrib>Sugaya, Tatsuro</creatorcontrib><creatorcontrib>Fujita, Masashi</creatorcontrib><creatorcontrib>Nakamura, Jun</creatorcontrib><creatorcontrib>Imaizumi, Hiromichi</creatorcontrib><creatorcontrib>Abe, Kazumichi</creatorcontrib><creatorcontrib>Takahashi, Atsushi</creatorcontrib><creatorcontrib>Takagi, Tadayuki</creatorcontrib><creatorcontrib>Hikichi, Takuto</creatorcontrib><creatorcontrib>Ohira, Hiromasa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hayashi, Manabu</au><au>Sugaya, Tatsuro</au><au>Fujita, Masashi</au><au>Nakamura, Jun</au><au>Imaizumi, Hiromichi</au><au>Abe, Kazumichi</au><au>Takahashi, Atsushi</au><au>Takagi, Tadayuki</au><au>Hikichi, Takuto</au><au>Ohira, Hiromasa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>59</volume><issue>21</issue><spage>2705</spage><epage>2710</epage><pages>2705-2710</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 33-year-old man presented with hepatic encephalopathy and was diagnosed to have a noncirrhotic extrahepatic portosystemic shunt (NCPSS). He presented with abdominal pain 16 months after the NCPSS diagnosis. Computed tomography revealed thrombosis between the intrahepatic portal vein and the left internal iliac vein, including the NCPSS, and varices of the sigmoid colon. Thrombosis was treated with danaparoid sodium and antithrombin III followed by edoxaban. After treatment, the thrombosis disappeared from the intrahepatic portal vein, but it remained in the NCPSS. The sigmoid colon varices were followed up without any treatment. Follow-up is needed in NCPSS patients in order to make an early detection of complications.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>32669497</pmid><doi>10.2169/internalmedicine.4925-20</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anticoagulants - therapeutic use Antithrombin Case Report Chondroitin Sulfates - therapeutic use Colon Colon, Sigmoid - physiopathology Computed tomography congenital portosystemic shunt danaparoid Dermatan Sulfate - therapeutic use ectopic varices Factor Xa Inhibitors - therapeutic use Heparitin Sulfate - therapeutic use Hepatic encephalopathy Hepatic Encephalopathy - diagnosis Hepatic Encephalopathy - surgery Humans Internal medicine Male Portal vein Portal Vein - physiopathology Portal Vein - surgery portal vein thrombosis Portasystemic Shunt, Transjugular Intrahepatic - adverse effects Pyridines - therapeutic use Thiazoles - therapeutic use Thrombosis Thrombosis - complications Thrombosis - drug therapy Treatment Outcome Varicose Veins - etiology Varicose Veins - physiopathology Varicose Veins - therapy |
| title | Sigmoid Colon Varices due to Massive Thrombosis of a Noncirrhotic Extrahepatic Portosystemic Shunt |
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