{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T11:17:11Z","timestamp":1773055031697,"version":"3.50.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T00:00:00Z","timestamp":1541548800000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background and study aims\u2002Esophagogastric variceal bleeding (EGVB) is common in patients with portal vein thrombosis (PVT). Hereditary deficiencies in natural anticoagulant proteins, such as protein S, might contribute to PVT. However, recurrent EGVB caused by PVT in patients with protein S deficiency is seldom reported. Herein, we present the case of a 38-year-old man with protein S deficiency complicated with PVT. The patient suffered recurrent EGVB for 7 years. He underwent splenectomy plus pericardial revascularization and sequential endoscopic therapy, including one gastric variceal obturation (GVO) procedure and two esophageal variceal ligations (EVL) to eradicate the varices. Rivaroxaban was administrated to reduce risk of thrombotic events. The patient is currently well without rebleeding after 1 year of follow-up.\u200aTo our knowledge there is no consensus on management of recurrent EGVB on the basis of thrombophilia complicated with PVT. According to our practice, sequential endoscopic therapy combined with anticoagulant appears to be effective and safe.<\/jats:p>","DOI":"10.1055\/a-0684-9638","type":"journal-article","created":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T23:40:29Z","timestamp":1541634029000},"page":"E1283-E1288","source":"Crossref","is-referenced-by-count":5,"title":["Recurrent esophagogastric variceal bleeding due to portal vein thrombosis caused by protein S deficiency"],"prefix":"10.1055","volume":"06","author":[{"given":"Haoxiong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieying","family":"Xuan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianyi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,11,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e365","DOI":"10.1161\/CIRCULATIONAHA.111.044412","article-title":"Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin","volume":"124","author":"B Lipe","year":"2011","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3350\/kjhep.2010.16.2.176","article-title":"Deficiencies in proteins C and S in a patient with idiopathic portal hypertension accompanied by portal vein thrombosis","volume":"16","author":"S Hwang","year":"2010","journal-title":"Korean J Hepatol"},{"key":"ref3","first-page":"104","article-title":"Portal and mesenteric thrombosis associated with protein S deficiency","volume":"100","author":"V JA Chirinos","year":"2008","journal-title":"Rev Esp Enferm Dig"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1046\/j.1365-2141.2001.02813.x","article-title":"A study of Protein S antigen levels in 3788 healthy volunteers: influence of age, sex and hormone use, and estimate for prevalence of deficiency state","volume":"113","author":"A C Dykes","year":"2001","journal-title":"Br J Haematol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1111\/j.1365-2516.2008.01775.x","article-title":"Protein S deficiency: a clinical perspective","volume":"14","author":"M K ten Kate","year":"2008","journal-title":"Haemophilia"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1002\/hep.20591","article-title":"Risk factors for thrombophilia in extrahepatic portal vein obstruction","volume":"41","author":"M Primignani","year":"2005","journal-title":"Hepatology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/hep.510310307","article-title":"Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors","volume":"31","author":"M H Denninger","year":"2000","journal-title":"Hepatology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1053\/gast.2001.21209","article-title":"Current outcome of portal vein thrombosis in adults: risk and benefit of anticoagulant therapy","volume":"120","author":"B Condat","year":"2001","journal-title":"Gastroenterology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1002\/hep.28466","article-title":"Natural history and management of esophagogastric varices in chronic noncirrhotic, nontumoral portal vein thrombosis","volume":"63","author":"F C Noronha","year":"2016","journal-title":"Hepatology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S1499-3872(16)60129-7","article-title":"Transjugular intrahepatic portosystemic shunt versus open splenectomy and esophagogastric devascularization for portal hypertension with recurrent variceal bleeding","volume":"16","author":"A P Su","year":"2017","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1016\/S0039-6109(16)43191-9","article-title":"Complications of splenectomy. Etiology, prevention, and management","volume":"63","author":"E C Ellison","year":"1983","journal-title":"Surg Clin North Am"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.14740\/gr806w","article-title":"Efficacy and safety of direct-acting oral anticoagulants use in acute portal vein thrombosis unrelated to cirrhosis","volume":"10","author":"F Nery","year":"2017","journal-title":"Gastroenterology Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/liv.13285","article-title":"Antithrombotic treatment with direct-acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis","volume":"37","author":"A De Gottardi","year":"2017","journal-title":"Liver Int"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/jth.12485","article-title":"Effectiveness and safety of novel oral anticoagulants as compared with vitamin K antagonists in the treatment of acute symptomatic venous thromboembolism: a systematic review and meta-analysis","volume":"12","author":"T van der Hulle","year":"2014","journal-title":"J Thromb Haemost"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s11239-016-1428-2","article-title":"The use of direct oral anticoagulants in inherited thrombophilia","volume":"43","author":"J W Skelley","year":"2017","journal-title":"J Thromb Thrombolysis"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.gie.2007.08.023","article-title":"Endoscopic treatment of esophagogastric variceal bleeding in patients with noncirrhotic extrahepatic portal vein thrombosis: a long-term follow-up study","volume":"67","author":"M C Spaander","year":"2008","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0684-9638.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T05:13:40Z","timestamp":1720761220000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0684-9638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2018,11,7]]},"published-print":{"date-parts":[[2018,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0684-9638","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}