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Idiopathic mesenteric thrombosis following caesarean section
P McGurgan1, M Holohan, P McKenna
1Mater Hospital, Dublin.
Irish Journal of Medical Science
|November 30, 1999
Summary
Mesenteric venous thrombosis (MVT) is rare in pregnancy, even without risk factors. Early diagnosis and anticoagulation are crucial for managing this serious postpartum complication.
Area of Science:
- Obstetrics and Gynecology
- Vascular Surgery
- Thrombosis Research
Background:
- Mesenteric venous thrombosis (MVT) is an uncommon but serious condition, particularly during pregnancy and the postpartum period.
- It can occur even without pre-existing thrombophilia or autoimmune disorders, presenting diagnostic challenges.
Observation:
- A case of extensive small bowel resection (150 cm) due to gangrene following an uncomplicated elective Cesarean section is presented.
- The patient's only identified risk factor was recovery from the elective Cesarean section, considered low risk for thrombosis.
Findings:
- Thromboembolism is a leading cause of maternal mortality, necessitating consideration of MVT in unusual postpartum symptoms.
- Elevated GST isoenzyme levels may aid in the early diagnosis of mesenteric vascular occlusion.
- Anticoagulation is the cornerstone of MVT treatment, with significantly lower recurrence rates in heparinized patients.
Implications:
- This case highlights the importance of considering MVT in postpartum patients with atypical symptoms, even with a low-risk profile.
- Effective management involves prompt anticoagulation (e.g., warfarin, heparin prophylaxis in future pregnancies) and avoiding oral contraceptives.
- Further research into diagnostic markers like GST isoenzymes could improve early detection and patient outcomes.