Portal vein thrombosis associated with ischemic colitis

We report the case of a 52-year-old male who was admitted for sudden abdominal pain and hematochezia. Colonoscopy showed erosion and edema in the mucosa of the descending colon, leading to a diagnosis of ischemic colitis. Blood tests revealed hepatic dysfunctions. Using abdominal ultrasonography (US), thrombus was observed in the left branch of the portal vein and a part of the right branch. Although the Doppler method detected blood flow in the right branch, no blood flow signal was observed in the left branch. Since coagulation examinations were almost normal, and there was no past history of liver cirrhosis or malignancy, it was diagnosed to be portal vein thrombosis (PVT) associated with ischemic colitis. Anticoagulation therapy was initiated for PVT. According to the results of the US and abdominal computed tomography performed 3 months after starting the treatment, thrombus in the right branch had diminished but remained in the umbilical region of the left branch. Due to atrophy of the lateral segment of the liver, we terminated the treatment. Ischemic colitis is not a rare disease; however, when accompanying hepatic dysfunction, it is necessary to take the complications associated with PVT into consideration.