Bedside ultrasound diagnosis of portal vein thrombosis following cholecystectomy: a case report

Portal vein thrombosis is a condition when the thrombus is blocking or nar rowing blood flow of the portal vein. The initial approach in diagnosis of portal vein thrombosis for a non-transportable critically ill patient is a colour Doppler ultrasonography. We present a case of an 82-year-old female with partial portal vein thrombosis following urgent cholecystec tomy and choledochotomy. The clinical deterioration of the patient with hemo dynamic and respiratory instability, acute renal failure, liver damage and metabolic acidosis, prevented the patient’s transport for computed tomography diagnostics. A bedside abdominal ultrasonography was performed and revealed a partial obstruc tion of the left branch of the portal vein, while a confluent part of the portal vein showed a complete absence of flow. Thera py with low molecular weight heparin was immediately started. Definitive confirma tion of portal vein thrombosis with the ab dominal computed tomography imaging was possible almost 24 hours after clinical and laboratory deterioration. This case il