Scindeks Asistent Scindeks Asistent — sistem za ozbiljne časopise i one koji to žele da postanu
Vol. 80 Br. 07 (2023)
Vol. 80 Br. 07 (2023)

Kratkotrajno konzervativno lečenje bolesnika sa trombozom vene porte bez maligniteta i ciroze

DOI: 10.2298/VSP210731084B
Jelena Bošković Sekulić
University Clinical Center Kragujevac, Center for Urgent Medicine, Kragujevac, Serbia
Igor Sekulić
Military Medical Academy, Institute for Radiology, Belgrade, Serbia
Nemanja Rančić
Military Medical Academy, Institute for Radiology, Belgrade, Serbia
Mina Stanić
University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Miloš Jovićević
Military Medical Academy, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Nenad Perišić
Military Medical Academy, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
PDF (engleski)

Objavljeno

2023-08-01

Sekcija

Prikaz bolesnika

Sažetak

Uvod. Tromboza vene porte (TVP) je delimična ili potpuna opstrukcija protoka krvi, nastala kao rezultat prisustva trombne mase u lumenu portalne vene (PV). U akutnoj fazi, simptomi kao što su bol u desnom gornjem kvadrantu, mučnina i groznica, nespecifični su. Raznolikost subakutnih i hroničnih simptoma povezana je sa komplikacijama vezanim za TVP i portalnu hipertenziju. Prikaz bolesnika.  Žena starosti 50 godina, primljena je u bolnicu zbog akutnih bolova u stomaku u vidu grčeva. Bol je trajao od 15 do 20 min, nakon čega je usledila defekacija normalne stolice i hematohezija u tri navrata. Bol u stomaku se ponovio kroz nekoliko sati, nakon čega su ponovo usledili hematohezija i tenezmi, svakih 10 min. Nakon prijema, urađena je kolonoskopija pomoću koje je otkrivena vulnerabilna, eritematozna sluznica debelog creva, sa kontaktnim krvarenjem u dužini od lijenalne fleksure do rektosigmoidnog prelaza. Tokom kolonoskopije urađena je i biopsija. Primenom kompjuterizovane tomografije (KT) otkrivena je parcijalna TVP, tromboza intrahepatičnih grana PV i tromboza donje mezenterične vene. Nakon konzervativnog lečenja niskomolekularnim heparinom (NMH) i drugom suportivnom terapijom, krvarenje u digestivnom traktu je prestalo, a defekacija je postala normalna. Tokom mesec dana praćenja, bolesnica nije imala komplikacija, a kontrolni pregled KT pokazao je normalan protok kroz PV, bez tromboze. Zaključak. Iako je retka, TVP kod bolesnika bez maligniteta i ciroze ne treba da se zanemari u diferencijalnoj dijagnozi, jer pravovremena i adekvatna terapija NMH može dovesti do potpunog izlečenja, bez teških komplikacija.

Ključne reči

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DOI: 10.2298/VSP210731084B

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