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Case Reports in Gastrointestinal Medicine
Volume 2015, Article ID 934784, 6 pages
http://dx.doi.org/10.1155/2015/934784
Case Report

Clinical Outcome of a Portosplenomesenteric Venous Thrombosis in Necrotizing Acute Pancreatitis with Protein C and S Deficiency Treated by Anticoagulation Therapy Alone

1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde University Teaching Hospital, Yaoundé, Cameroon
2Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde University Teaching Hospital, Yaoundé, Cameroon
3Department of Radiology and Imaging, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon
4Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde General Hospital, Yaoundé, Cameroon

Received 24 April 2015; Revised 24 August 2015; Accepted 30 August 2015

Academic Editor: Hideto Kawaratani

Copyright © 2015 Firmin Ankouane et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cases of splanchnic venous thrombosis have not been described in Cameroon. Their prevalence in acute pancreatitis is variable. With the emergence of acute intra-abdominal infections including typhoid fever and peritoneal tuberculosis in situations of acquired immunodeficiency syndrome, these cases will become frequent. We report the case of a portosplenomesenteric venous thrombosis related to necrotizing acute pancreatitis associated with proteins C and S deficiency, in a 46-year-old Cameroonian man, without particular past medical history. He was admitted for abdominal pain which had been evolving for 3 weeks and accompanied by vomiting. In the absence of hemorrhagic risk factor, the patient received low molecular weight heparin followed by oral warfarin. The abdominal ultrasound check on the 12th day showed a partial recanalization of venous thrombosis. The abdominal contrast-enhanced CT scanner at day 30 on oral anticoagulation therapy showed collateral vessels and small bowel edema. At the same time the upper gastrointestinal endoscopy showed grade II esophageal varices. We have maintained oral anticoagulation therapy. This case highlights that an early effective anticoagulation heparin therapy is needed for a clear benefit in case of suspected PSMVT. It is certain that the sooner the treatment is given, the better outcome will be.