Transhepatic thrombolysis in acute portal vein thrombosis after laparoscopic splenectomy.

Portal vein thrombosis is a relatively rare clinical entity that can result in substantial morbidity and mortality. Because of the risk of intestinal infarction, acute symptomatic portal vein thrombosis requires prompt intervention. Traditional treatment has included anticoagulation and/or systemic thrombolytic therapy. We report the successful management of acute portal vein thrombosis with percutaneous transphepatic thrombolytic therapy. In addition to the potential for improving regional clot lysis through direct infusion of the thrombolytic agent, this method may result in fewer systemic side effects than occur with other available treatment modalities.