Splenopneumopexy: Decompression of Portal Hypertension in the Setting of Portal Venous Occlusive Disease

Excerpt

BG is a 27-year-old man originally diagnosed with portal, splenic, and superior mesenteric vein thrombosis in 2007 during a work-up for abdominal pain. A subsequent hypercoagulable work-up was negative. He was placed on oral anticoagulation as an outpatient but failed due to repeated noncompliance. He represented in 2012 with massive upper gastrointestinal hemorrhage from his esophagogastric varices, requiring placement of a Minnesota tube to facilitate bleeding cessation. The patient underwent a protracted surgical intensive care unit course with numerous packed red blood cell transfusions. He eventually stabilized with sclerotherapy consisting of intravariceal cyanoacrylate injection, but he remained in-house for continued monitoring and occasional ongoing transfusions. …