[Acute mesenteric vein thrombosis: diagnosis and management]

To evaluate the progress in diagnosis and management of acute mesenteric vein thrombosis (AMVT).

Fifteen patients with AMVT treated from January 1983 to November 1998 were reviewed retrospectively. They were 7 men and 8 women, aged on average 42 years. The duration from onset of symptoms to admission was 24 - 168 hours (mean 84 hours).

Six patients were diagnosed before operation, while 9 during laparotomy. Two patients received conservative treatment and the rest underwent surgery. The average length of bowel resection was 300 cm. All the patients received anticoagulation therapy with heparin immediately after operation. Local thrombolytic therapy was given to 4 patients. Four patients died in hospital and two had sequelae of short bowel syndrome.

AMVT is rare but a potentially lethal emergency disease. Early diagnosis, anticoagulation and appropriate surgical approach are essential to improve the prognosis. It is important to keep vigilance for AMVT in the patients in the hypercoagulation status, especially when the symptoms are inconsistent with abdominal signs. Color-US and CT appear to be sensitive in the diagnosis of this condition. Local thrombolytic therapy will be effective. Second-look is a necessarily procedure for reserving the bowel that may be alive. Laparoscopy technique will play an important role in the diagnosis and treatment for AMVT.