Thrombosis of portal and hepatic veins is one of the most severe complications and most important causes of death of patients with chronic myeloproliferative diseases. Based on results of the past studies, myeloproliferative diseases were the causes of hepatic veins
thrombosis in 30% and portal vein
thrombosis in 20% of patients. The study presented 4 patients with myeloproliferative diseases complicated by
thrombosis of splanchnic veins, aiming at the illustration of issue complexity in diagnostics and
therapy. Two patients with portal vein
thrombosis and recurring
hemorrhage from esophageal varicosity were described. The first case was planned for shunting, while another case sustained
bleeding on what account his
anticoagulant therapy was discontinued, but it caused mesenterial
thrombosis resulting in lethal outcome. Another two patients had hepatic veins
thrombosis. Due to frequent, life-threatening
bleeding from the
esophageal and gastric varices, a patient with chronic
Budd-Chiari syndrome and lineal vein
thrombosis underwent mesocaval shunting. An immediate postoperative period was manifested by multiple
thrombosis and
hemorrhages that ended in his death. A patient with the acute
Budd-Chiari syndrome was administered myelosuppressants and
anticoagulants on time so reperfusion was restored. In myeloproliferative diseases,
thrombosis of portal and hepatic veins gives rise to excessive
portal hypertension with profuse
hemorrhage from the esophageal and gastric varicosity which is difficult to manage because of complex coagulation disorders.