A Case Report of Modified Hinchey II Colonic Diverticulitis Complicating Portal Vein Thrombosis Treated with Elective Surgery
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- Yamaguchi Hiroshi
- Department of Surgery, Higashi-Sapporo Hospital Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
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- Kashiwagi Kiyoteru
- Department of Surgery, Higashi-Sapporo Hospital
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- Kihara Chikashi
- Department of Surgery, Sapporo Doto Hospital
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- Kuga Yoko
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Department of Breast Surgery, Higashi-Sapporo Hospital
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- Ito Satoko
- Department of Internal Medicine, Higashi-Sapporo Hospital
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- Watanabe Nanae
- Department of Internal Medicine, Higashi-Sapporo Hospital
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- Kondo Nobuo
- GeneticLab Co., Ltd.
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- Imamura Masafumi
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
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- Nagayama Minoru
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
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- Nobuoka Takayuki
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
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- Kimura Yasutoshi
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
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- Ohmura Tosei
- Department of Breast Surgery, Higashi-Sapporo Hospital
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- Hata Fumitake
- Department of Surgery, Sapporo Doto Hospital
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- Takemasa Ichiro
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University
Bibliographic Information
- Other Title
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- 門脈血栓症を合併したmodified Hinchey IIの結腸憩室炎に対して待機的手術を施行した1例
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Description
<p>A 77-year-old male patient presented to our hospital with a chief complaint of lower abdominal pain. Plain CT on admission demonstrated peri-appendiceal and intrapelvic fluid collections with multiple diverticula in the right colon, without an identified appendix, suggesting peri-appendiceal and intrapelvic abscesses caused by appendicitis or diverticulitis. Due to the general condition being impaired, conservative antimicrobial treatment was initiated. Portal vein thrombosis was subsequently diagnosed by contrast-enhanced CT on hospital day 4, and treated with heparin and antithrombin III. The patient resumed an oral diet on hospital day 14, and anticoagulation therapy was switched to edoxaban per-oral. He was discharged on hospital day 29. Post-discharge close examination revealed no abnormality in the appendix, leading to a diagnosis of portal vein thrombosis complicating an intra-abdominal abscess caused by diverticulitis. Laparoscopic right hemicolectomy was performed 3.5 months after initial discharge, after which the patient was discharged uneventfully. There has been no evidence of exacerbation of portal vein thrombosis or any symptoms attributed to the diverticulum for 1 year after surgery. We herein present a rare case of portal vein thrombosis associated with colonic diverticulitis, for which there are limited reports of conservative treatment followed by elective surgery.</p>
Journal
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- The Japanese Journal of Gastroenterological Surgery
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The Japanese Journal of Gastroenterological Surgery 56 (7), 409-418, 2023-07-01
The Japanese Society of Gastroenterological Surgery
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Details 詳細情報について
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- CRID
- 1390015443654994944
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- ISSN
- 13489372
- 03869768
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed