[Portal vein thrombosis in a patient with lowered protein S level].

HISTORY AND CLINICAL FINDINGS: In a 39-year-old man with increasing spasmodic epigastric pain, nausea and vomiting, varices of the esophagus and the gastric fundus were found endoscopically.

INVESTIGATIONS: A portal vein thrombosis and a consecutive thrombosis of the splenic vein were diagnosed by colour Doppler sonography and angio CT. A protein S deficiency (59 %) was found to be the underlying illness.

TREATMENT AND COURSE: The thrombosis and the resulting clinical symptoms completely resolved shortly after starting therapeutic heparinization. For six months, the patient has been without complaints or clinical symptoms.

CONCLUSION

Hence, an isolated protein S deficiency can be the cause for a portal vein thrombosis.