Frische venöse Thrombose splanchnischer Gefäße

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• 作者：M. Praktiknjo ; C. Meyer ; C. P. Strassburg ; Prof. Dr. J. Trebicka
• 关键词：SchlüsselwörterPfortader ; V. mesenterica superior ; V. lienalis ; Transjugulärer ; intrahepatischer portosystemischer Shunt ; Interventionelle radiologische Verfahren
• 刊名：Der Internist
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：58
• 期：1
• 页码：82-89
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Internal Medicine; General Practice / Family Medicine; Cardiology; Gastroenterology; Hepatology; Nephrology;
• 出版者：Springer Medizin
• ISSN：1432-1289
• 卷排序：58

文摘

Recent non-cirrhotic and non-malignant splanchnic vein thrombosis is now defined as extrahepatic portal vein thrombosis with or without involvement of the mesenteric vein according to the Baveno VI consensus from 2015. An early diagnosis is often challenging due to unspecific symptoms with abdominal pain or diarrhea but extremely important because of the potential acute and chronic complications, such as mesenteric ischemia and portal hypertension; therefore, rapid treatment is crucial. We present two cases of severe splanchnic vein thrombosis, which were treated with catheter-directed local thrombolysis and thrombus aspiration. These minimally invasive catheter-directed techniques have recently been successfully used in selected patients. A review of the literature is provided in this article. In summary, the management of splanchnic vein thrombosis must be individually planned for each patient and should be performed at experienced centers, which can provide all therapeutic options. In selected cases with the correct indications transjugular transhepatic catheter-directed local thrombolysis is a safe option with a good outcome.