A 70-year-old patient with liver cirrhosis virus C with portal hypertension, Child-Pugh stage B, with previous episodes of upper gastrointestinal bleeding secondary to esophageal varices and edemoascitic varices.
Being on the active list of liver transplants, in an ultrasound check for hepatocellular carcinoma screening, two 3 and 1.5 cm hepatic LOES are detected, compatible with hepatocellular carcinoma in two imaging techniques (abdominal CT).
Percutaneous treatment was initiated by ethanolization of the larger LOE, with three sessions.
In the control abdominal ultrasound, after three days from the last ethanolization, a thrombosis was observed in the trunk of the portal vein and main branches, which we explored with abdominal ultrasound with contrast (SonoVue®), with no posterior enhancement.
The CT and FNA performed later confirmed the origin of the thrombus.
Since this is a finding not present in previous ultrasounds or abdominal CAT scans, detected in ultrasound after percutaneous treatment and the study with SonoVue®, CT and portal vein FNA confirmed the origin of ethanol.
We began treatment with low molecular weight heparin at a dose of 1 mg/kg/day subcutaneously, proving in controls branch and partial portal vein treatment since thrombosis has improved since after 22 days of treatment only is present.
Finally, the patient remains without complications.
