A 56 year-old woman was admitted to our hospital for treatment of a severe exacerbation of Crohn's disease. During the stay a port catheter was implanted, safeguarding nutrition. A few days later the patient developed symptoms of a severe superior vena cava (SVC) syndrome with dyspnea, cyanosis, headaches and swelling of face and upper extremities. A CT scan showed port catheter-associated SVC thrombosis with complete occlusion of the SVC. There was a coexistence of a port catheter-associated SVC thrombosis with complete occlusion of the SVC and a severe exacerbation of Crohn's disease with haematochezia. Local prolonged thrombolysis through the port catheter analogous to the regimen used in the 2012 CaVenT Study was started. Subsequently, symptoms of SVC obstruction as well as thrombus extent improved markedly, with only minor increase in gastrointestinal bleeding. Local thrombolysis appears to be a safe and effective therapy for port catheter-associated thrombosis that may be considered in the setting of increased risk of hemorrhage.
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