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Mesenteric venous thrombosis in inflammatory bowel disease
Ossama A Hatoum1, Kristi S Spinelli, Majed Abu-Hajir
1Division of Cardiovascular Medicine, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Journal of Clinical Gastroenterology
|December 16, 2004
Summary
Mesenteric venous thrombosis (MVT) is a rare complication in inflammatory bowel disease (IBD) patients. Early diagnosis with CT scans is crucial, especially during the perioperative period, to manage contributing factors and improve outcomes.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Internal Medicine
Background:
- Inflammatory bowel disease (IBD) is associated with an increased risk of mesenteric venous thrombosis (MVT).
- Clinical factors predisposing IBD patients to MVT remain incompletely understood.
- Nonspecific abdominal symptoms in IBD can delay MVT diagnosis.
Observation:
- A retrospective review identified 6 cases (1.1%) of MVT among 545 IBD patients.
- Mesenteric venous thrombosis diagnosis was confirmed via abdominal computed tomography (CT) in 5 out of 6 patients.
- Contributing factors included hypercoagulability, low-flow states, uncontrolled inflammation, and perioperative status.
Findings:
- No MVT-related deaths occurred in the observed cohort.
- One patient developed severe portal hypertension.
- Another patient required extensive intestinal resection due to infarction.
Implications:
- Mesenteric venous thrombosis should be considered in IBD patients, particularly perioperatively.
- Abdominal CT scans are valuable for diagnosing MVT in this population.
- Identifying and managing contributing factors is essential for improving patient outcomes.