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[Mesenteric venous thrombosis: early diagnosis with abdominal CT scan and screening for coagulopathies. Six
K Soulier1, I Delèvaux, M André
1Service de médecine interne, hôpital Gabriel-Montpied, 69 BP, 63003 Clermont-Ferrand, France.
Purpose:
Mesenteric venous thrombosis is an uncommon entity whose diagnosis is difficult because the symptoms are nonspecific. Yet early recognition of this disease helps avoid the evolution towards mesenteric infarction.
Methods:
We describe clinical symptoms and hypercoagulable states discovered in six patients with superior mesenteric venous thrombosis.
Results:
Five of six patients were admitted to hospital for abdominal pain whose mean duration was 9 days before the diagnosis of venous thrombosis was made. Three of them had a fever. Two patients had a past history of deep venous thrombosis. All patients had a hypercoagulable state and three of them had two associated disorders of coagulation. In all cases, abdominal CT scan had permitted the diagnosis of mesenteric venous thrombosis. An anticoagulant therapy was conducted successfully in five of six patients.
Conclusion:
A CT abdominal scan done early in the case of nonspecific abdominal pain, since the patients had a previous history of venous thrombosis, may permit a nonsurgical treatment of mesenteric venous thrombosis. A screening for thrombophilia must always be carried out since coagulation disorders are very frequently the recognised causes in mesenteric venous thrombosis.