Abstract

GONZALEZ, Celso et al. Trombosis venosa portal extrahepática asociada a infección por citomegalovirus en una paciente con síndrome mielodisplásico: Reporte de un caso y revisión de la literatura. Gen [online]. 2010, vol.64, n.4, pp.356-358. ISSN 0016-3503.

Introduction: Extrahepatic portal vein thrombosis (EHPVT) occurs in early stages of life as a complication of omphalitis, cannulation of the umbilical vein, intra-abdominal sepsis, dehydration, and hypercoagulable states, mainly C and S proteins deficiencies, post-traumatic, portal vein manipulation, pancreatitis, as well as tumor invasion or obstruction. Etiology is unknown in half of these cases. In the literature, there are reports of EHPVT associated with severe infectious processes such as sepsis by Fusobacterium necrophorum, Fusobacterium nucleatum, as well as infection by Cytomegalovirus (CMV). Nonetheless, such reports are very scarce. Clinical Case: Female patient aged 56, con antecedent myelodysplastic syndrome, who attends the clinic with diffuse abdominal pain, obstructive icterus, and liver function disturbances. Among the assessments performed, an Endoscopic Ultrasound (EUS) is carried out evidencing upper mesenteric and deep portal vein thrombosis with portal hypertension, esophageal and fundic varices. A probable infectious origin is stated, thus serology is requested for CMV with elevated levels of IgG; antiviral treatment is started with Valgancyclovir and Beta-Blockers with satisfactory evolution after one year. Conclusion: Despite the portal vein thrombosis associated with the infection by CMV is a rare event in immunocompetetnt persons, discarding it must be included in a diagnosis plan for splenic-portal bed thrombosis.

Keywords : Extrahepatic portal vein thrombosis; portal vein thrombosis; upper mesenteric vein thrombosis; myelodysplastic syndrome; infection by Cytomegalovirus; endoscopic ultrasound.