CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(11): E1283-E1288
DOI: 10.1055/a-0684-9638
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Recurrent esophagogastric variceal bleeding due to portal vein thrombosis caused by protein S deficiency

Haoxiong Zhou
Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
,
Jieying Xuan
Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
,
Xianyi Lin
Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
,
Yunwei Guo
Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
› Author Affiliations
Further Information

Publication History

submitted 13 March 2018

accepted after revision 30 May 2018

Publication Date:
07 November 2018 (online)

  

Abstract

Background and study aims Esophagogastric variceal bleeding (EGVB) is common in patients with portal vein thrombosis (PVT). Hereditary deficiencies in natural anticoagulant proteins, such as protein S, might contribute to PVT. However, recurrent EGVB caused by PVT in patients with protein S deficiency is seldom reported. Herein, we present the case of a 38-year-old man with protein S deficiency complicated with PVT. The patient suffered recurrent EGVB for 7 years. He underwent splenectomy plus pericardial revascularization and sequential endoscopic therapy, including one gastric variceal obturation (GVO) procedure and two esophageal variceal ligations (EVL) to eradicate the varices. Rivaroxaban was administrated to reduce risk of thrombotic events. The patient is currently well without rebleeding after 1 year of follow-up. To our knowledge there is no consensus on management of recurrent EGVB on the basis of thrombophilia complicated with PVT. According to our practice, sequential endoscopic therapy combined with anticoagulant appears to be effective and safe.