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Deciphering mesenteric venous thrombosis: imaging and treatment.
Andre Grisham1, Joann Lohr, J Michael Guenther
1Department of Surgery, Good Samaritan Hospital, Cincinnati, OH 45220, USA.
Vascular and Endovascular Surgery
|December 31, 2005
Summary
Early diagnosis and anticoagulation significantly reduce mortality from mesenteric vein thrombosis (MVT). Prompt treatment preserves bowel viability and avoids surgery, decreasing overall death rates.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Radiology
Background:
- Mesenteric vein thrombosis (MVT) historically has a high mortality rate, primarily due to diagnostic delays.
- Recent trends show decreasing mortality due to earlier diagnosis and anticoagulation strategies.
Purpose of the Study:
- To examine the treatment profile of acute MVT.
- To assess the impact of increased imaging use and early anticoagulation on MVT treatment outcomes.
Main Methods:
- Retrospective analysis of acute MVT cases at a single institution over a 10-year period (1993-2003).
- Data analysis included chi-squares and Student's t tests.
- Identified patient demographics, thrombosis locations, treatment interventions (thrombolytics, anticoagulation, surgery), and outcomes.
Main Results:
- Twenty-three patients with acute MVT were identified.
- The overall mortality rate was 8.7% (2 of 23).
- Thrombolytic use was associated with increased mortality (p=0.04), while prompt anticoagulation preserved bowel viability and reduced morbidity/mortality.
Conclusions:
- Early diagnosis and prompt anticoagulation are crucial for improving outcomes in MVT.
- The majority of MVT patients do not require surgical intervention, and progression to surgery is associated with increased mortality.
- Increased awareness and early diagnosis have led to decreased morbidity and mortality rates for MVT.