Portal vein thrombosis is a condition when the thrombus is blocking or narrowing blood flow of the portal vein. The initial approach in diagnosis of portal vein thrombosis for a non-transportable critically ill patient is a colour Doppler ultrasonography. We present a case of an 82-year-old female with partial portal vein thrombosis following urgent cholecystectomy and choledochotomy. The clinical deterioration of the patient with hemodynamic and respiratory instability, acute renal failure, liver damage and metabolic acidosis, prevented the patient’s transport for computed tomography diagnostics. A bedside abdominal ultrasonography was performed and revealed a partial obstruction of the left branch of the portal vein, while a confluent part of the portal vein showed a complete absence of flow. Therapy with low molecular weight heparin was immediately started. Definitive confirmation of portal vein thrombosis with the abdominal computed tomography imaging was possible almost 24 hours after clinical and laboratory deterioration. This case illustrates the importance of rapid bedside ultrasonography in diagnosis of thromboembolic events in the abdomen.

Key words: bedside ultrasonography, portal vein thrombosis, liver dysfunction

Read More