 |
Case Report
Portal vein thrombosis and splenic collection after transrectal prostate biopsy in Janus Kinase 2 positive myeloproliferative disorder
1 Urology Department, Ashford & St. Peter’s Hospital, Chertsey, UK
Address correspondence to:
F. A. Maqboul
Urology department, Ashford & St. Peter’s hospital, Chertsey,
UK
Message to Corresponding Author
Article ID: 101007Z01FM2019
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Maqboul FA, Tadtayev S. Portal vein thrombosis and splenic collection after transrectal prostate biopsy in Janus Kinase 2 positive myeloproliferative disorder. Int J Case Rep Images 2019;10:101007Z01FM2019.ABSTRACT
Introduction: Transrectal ultrasound guided biopsy prostate biopsy has its infective complications especially in immunocompromised patients; portal vein thrombosis is a severe form of its complications.
Case Report: A 66-year-old male, with background of myeloproliferative disorder (JAK2 positive). Underwent TRUS biopsy, later developed intra-abdominal sepsis with portal vein thrombosis and splenic collection. Multi-disciplinary team approach agreed on conservative management with intravenous antibiotics and full anti-coagulation and ultrasound guided aspiration of the splenic collection. Patient had full investigations including Computed Tomography scans at presentation, an ultrasound-guided aspiration of spleen and full septic and viral study. Patient had full recovery with spleen salvage. Follow up ultrasound study revealed partial recanalization of the portal vein. From the urology perspective, prostate biopsy histology showed microacinar adenocarcinoma and patient enlisted on active surveillance programme. In addition, Hydroxycarbamide recommended by hematologist for the essential thrombocytosis management.We discuss our case as a rare complication of TRUS prostate biopsy, precipitated with background of Janus Kinase 2 positive myeloproliferative disorder. Strategies to minimize the risk of sepsis after prostate biopsy include targeted prophylaxis with a prior rectal swab and transperineal biopsy route. We discuss also the immunocompromised and thrombogenicity state of our case with the challenges in the management choice between conservative management and splenectomy with its complications.
Conclusion: The immune compromised patients requiring evaluation with a prostate biopsy, would benefit from a transperineal rather than transrectal prostate biopsy. Furthermore, an individual antibiotic prophylaxis strategy should be discussed with a microbiologist.
Keywords: Myeloproliferative disorder, Portal vein thrombosis, Prostate biopsy
SUPPORTING INFORMATION
Author Contributions
F. A. Maqboul - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
S. Tadtayev - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 F. A. Maqboul et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
