A Case of Loss of Consciousness Due to Thrombosis of the Inferior Vena Cava and Portal Vein

We present a case where intraperitoneal venous thrombosis was difficult to treat. It is difficult to suspect intraperitoneal venous thrombosis in patients who have visited the hospital due to loss of consciousness, and it is necessary to administer anticoagulants early for treatment and to determine the appropriate timing for surgical intervention.The patient was a 78-year-old male who independently performed his daily activities. On the day of admission, he lost consciousness and was brought to our hospital. Computed tomography (CT) angiography revealed thrombi from the inferior vena cava and portal vein to the superior mesenteric vein, and the patient was started on anticoagulant therapy. The CT angiography images on day 7 of the illness revealed that the thrombus in the superior mesenteric vein expanded to the caudal side. Intestinal necrosis occurred on day 22 of the illness, and emergency laparotomy was performed. The chosen course of treatment was successful, and the patient was discharged on the 48th day.

Automated summary

This case describes a challenging treatment of intraperitoneal venous thrombosis. It is difficult to suspect this condition in patients admitted for loss of consciousness, thus early anticoagulant therapy and appropriate timing for surgical intervention are necessary. The patient was a 78-year-old male with independent daily activities. Computed tomography (CT) angiography revealed thrombi extending from the inferior vena cava and portal vein to the superior mesenteric vein, leading to anticoagulant therapy initiation. The CT angiography on day 7 showed expansion of the thrombus in the superior mesenteric vein, and emergency laparotomy was performed on day 22 for intestinal necrosis. The treatment was successful, and the patient was discharged on day 48.