Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1876
Peer-review started: July 5, 2021
First decision: October 11, 2021
Revised: October 22, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 26, 2022
Processing time: 233 Days and 11.8 Hours
Acute portal vein thrombosis (PVT) with bowel necrosis is a fatal condition with a 50%-75% mortality rate. This report describes the successful endovascular treatment (EVT) of two patients with severe PVT.
The first patient was a 22-year-old man who presented with abdominal pain lasting 3 d. The second patient was a 48-year-old man who presented with acute abdominal pain. Following contrast-enhanced computed tomography, both patients were diagnosed with massive PVT extending to the splenic and superior mesenteric veins. Hybrid treatment (simultaneous necrotic bowel resection and EVT) was performed in a hybrid operating room (OR). EVTs, including aspiration thrombectomy, catheter-directed thrombolysis (CDT), and continuous CDT, were performed via the ileocolic vein under laparotomy. The portal veins were patent 4 and 6 mo posttreatment in the 22-year-old and 48-year-old patients, respectively.
Hybrid necrotic bowel resection and transileocolic EVT performed in a hybrid OR is effective and safe.
Core Tip: Acute portal vein thrombosis (PVT) with bowel necrosis is a fatal condition with no definite cure. This report describes successful endovascular treatment (EVT) in two severe PVT cases. Hybrid treatment (simultaneous necrotic bowel resection and EVT) was performed in a hybrid operating room. EVTs, including aspiration thrombectomy, catheter-directed thrombolysis (CDT), and continuous CDT, were performed via the ileocolic vein under laparotomy. By performing this procedure, we were able to achieve a good result for a disease with a low survival rate and did so with minimal intestinal resection.