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Acute superior mesenteric venous thrombosis: one disease or two?
Shaji Kumar1, Patrick S Kamath
1Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.
The American Journal of Gastroenterology
|June 24, 2003
Summary
Acute mesenteric venous thrombosis (MVT) often has identifiable causes. Isolated MVT is harder to diagnose, more likely to need surgery, and linked to hypercoagulable disorders, but prognosis is good with low risk of variceal complications.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Hematology
Background:
- Acute mesenteric venous thrombosis (MVT) is a rare but serious condition.
- Understanding its causes and outcomes is crucial for patient management.
Purpose of the Study:
- To determine the etiology and natural history of acute mesenteric venous thrombosis (MVT).
- To compare outcomes of isolated MVT versus MVT with portal or splenic vein involvement.
Main Methods:
- Retrospective analysis of patients with acute MVT from 1979-1998.
- Review of case records and patient follow-up questionnaires.
- Etiological search for malignancy, infection, inflammatory bowel disease, and other risk factors.
Main Results:
- A specific etiology was identified in 35 of 69 patients.
- Isolated MVT was less likely to be diagnosed by imaging and more likely to require surgery.
- Inherited hypercoagulable disorders were more common in isolated MVT cases.
Conclusions:
- Classification of MVT based on vessel involvement has clinical and prognostic value.
- Isolated MVT presents diagnostic challenges and increased surgical risk.
- Patients have a good prognosis post-initial treatment, but recurrence risk exists.