저분자량 헤파린으로 치료된 급성 췌장염에 동반된 간문맥 혈전증

• Published in: The Korean journal of medicine Vol. 69; no. 5; pp. 541 - 544
• Main Authors: 고훈, Hoon Ko, 정성희, Sung Hee Jung, 윤상정, Sang Jeong Yoon, 김안나, An Na Kim, 전병민, Byung Min John, 최기영, Gi Young Choi, 김준형, Jun Hyoung Kim
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.11.2005
• Subjects: Anticoagulants; Pancreatitis; Venous thrombosis; 간문맥 혈전증; 췌장염; 항응고요법
• ISSN: 1738-9364

급성췌장염에 의해 이차적으로 발생한 간문맥 혈전증은 약 3~5%로 항응고요법으로 치료할 수 있는데 저분자량 헤파린으로 치료한 경우는 드물다. 저자들은 급성괴사성 췌장염에 동반된 급성 간문맥 혈전증을 저분자량 헤파린으로 성공적으로 치료한 1예를 경험하였기에 이를 보고하는 바이다. Portal vein thrombosis is an uncommon cause for presinusoidal hypertension, which results from inherited thrombotic disorder, neoplasm, and intra-abdominal inflammation like pancreatitis. It could develop portal hypertension, culminating in variceal bleeding from esophagus or stomach. One of the medical management of portal vein thrombosis is intravenous heparinization followed by long term oral anticoagulation. Intravenous heparinization using unfractionated heparin requires aPTT monitoring for dose adjustment which is not needed for low molecular weight heparin, and has higher risk of bleeding than using low molecular weight heparin. However, the standard protocol for anticoagulation in portal vein thrombosis has not been determined yet. We experienced a case of portal vein thrombosis in acute necrotizing pancreatitis, which was successfully treated with low molecular weight heparin, as herein reported.(Korean J Med 69:541-544, 2005)