Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 21, 2007; 13(27): 3767-3769
Published online Jul 21, 2007. doi: 10.3748/wjg.v13.i27.3767
Combination of thrombolytic therapy and angioplastic stent insertion in a patient with Budd-Chiari syndrome
Fatemi Reza, Daryani E Naser, Ganaati Hossein, Zahmatkesh Mehrdad
Fatemi Reza, Daryani E Naser, Ganaati Hossein, Zahmatkesh Mehrdad, Gastrointestinal & Liver Diseases Research Center, Semnan University of Medical Sciences, 17th Shahrivar Ave., Semnan, Iran
Author contributions: All authors contributed equally to the work.
Supported by Semnan University of Medical Sciences
Correspondence to: Fatemi Reza, MD, Gastrointestinal & Liver Diseases Research Center, Fatemieh Hospital, 17th Shahrivar Ave., Semnan, Iran. nedafat20@yahoo.com
Telephone: +98-231-3328017 Fax: +98-231-3334610
Received: February 22, 2007
Revised: April 10, 2007
Accepted: April 16, 2007
Published online: July 21, 2007
Abstract

A 31-year-old female who had well-established polycythemia vera one year before, presented with the sudden onset. She had severe ascites and hepatic encephalopathy 12 d prior to admission. Real-time ultrasonography revealed a supra hepatic thrombosis extending toward the inferior vena cava (lVC). Thrombolytic therapy with systemic streptokinase (250 000 IU loading + 100 000 IU/h infusion) was started. At the end of 72 h infusion, the patient's general condition improved. A color Doppler ultrasonography then showed complete and partial resolution of the thrombosis in the supra hepatic vein and IVC, respectively. Despite this good response, 12 d later, the symptoms recurred. Venography detected complete obstruction of the lVC. Percutanous balloon angioplasty with stent insertion was performed successfully and the patient was discharged without any evidence of liver disease. A combination of systemic streptokinase and radiological intervention was effective in our patient.

Keywords: Hepatic vein thrombosis; Anticoagulants; Thrombolytic therapy; Stents