Portal, splenic and mesenteric vein thrombosis in a patient with factor V Leiden mutation and antithrombin III deficiency.

摘要

We are writing to report the case of a 44-year-old obese lady who presented to the emergency department with a 1-week history of diffuse stabbing abdominal pain. The patient's review of systems, personal history as well as family history, were negative particularly for any episodes of venous thromboembolism (VTE) in the past. The patient's past surgical history was essentially negative as well except for three uncomplicated pregnancies delivered vaginally. The patient had recently visited her gynecologist with complaints of irregular menstruation and spotting. She had started, 25 days before admission, taking oral contraceptive pills (OCPs) to regulate her menstrual cycle. On physical examination, the patient was afebrile and she had diffuse abdominal tenderness with mild guarding but no overt signs of peritonitis. Bowel sounds were present but hypoactive. Laboratory findings were as follows: white blood cell count 20,200/mm3 with normal differential, hemoglobin 13.3 g/dl, and platelet count 295,000/mm3. Liver function tests, total protein, albumin, globulin, prothrombin time, and activated partial thromboplastin time (aPTT) were within normal limits.