Portal vein thrombosis successfully treated with a colectomy in active ulcerative colitis - Report of a case

Portal vein thrombosis is a rare complication in ulcerative colitis. We pre sent a patient with portal vein thrombosis in ulcerative colitis who was su ccessfully treated with colectomy. A 38-year-old Japanese female was admitt ed to our hospital because of an exacerbation of colitis. Abdominal ultraso nography performed because of liver dysfunction showed the thrombus in an u mbilical portion of the portal vein. The patient underwent a subtotal colec tomy and ileostomy because her colitis did not respond to intensive intrave nous therapy. Although portal vein thrombus was treated with an intravenous infusion of urokinase before the operation, no change in the thrombus size was found. Approximately three months after the colectomy, the thrombus of the portal vein disappeared without anticoagulant therapy. Although a rese ction of an inflamed colon map be theoretically effective in the thrombosis in the inflammatory bowel disease, its benefit has not been con fumed. Our case suggests that the resection of the diseased bowel may have a favorabl e effect on the course of portal vein thrombosis in acute attacks of ulcera tive colitis.