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Published on: June 2, 2015
Primary mesenteric venous thrombosis: a study from western India
Deepak N Amarapurkar1, Nikhil D Patel, Jignesh Jatania
1Gastroenterology Department, Bombay Hospital and Medical Research Center, Mumbai, India. amarapurkar@gmail.com
Introduction:
The prevalence and clinical spectrum of mesenteric venous thrombosis (MVT) in India is largely unknown.
Methods:
We retrospectively re-viewed the case records of patients with primary mesenteric venous thrombosis seen over a 10-year period and retrieved information on clinical picture, underlying hypercoagulable states and outcome.
Results:
The 28 cases (mean age 41.2 [SD 10.2] years; 19 male) included 13 with acute MVT, 10 with subacute MVT and 5 with chronic MVT. Ten patients had past thromboembolic events (multiple events in five); four patients had isolated superior mesenteric vein involvement and 14 had multiple vessel involvement. Hypercoagulable state was identified in 17 patients, with multiple etiologies in 7 patients. Pre-operative diagnosis was made in all patients. Ten patients needed surgical management; the rest were managed medically initially, but 2 required surgery on follow up. Seven patients died during a follow up of up to 10 years, with in-hospital mortality during index admission in six.
Conclusions:
Most of the patients with MVT have multiple intra-abdominal vessel involvement and underlying hypercoagulable state. The policy of early treatment with anticoagulation in all and surgical treatment as per need, achieves low mortality.
Insights
Mesenteric venous thrombosis (MVT) in India often involves multiple abdominal vessels and underlying hypercoagulable states. Early anticoagulation and timely surgery lead to reduced mortality in MVT patients.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Thrombosis Research
Background:
- The prevalence and clinical presentation of mesenteric venous thrombosis (MVT) in India remain largely uncharacterized.
- Understanding MVT's spectrum is crucial for effective patient management.
Purpose of the Study:
- To investigate the clinical features, underlying causes, and outcomes of mesenteric venous thrombosis (MVT) in an Indian population.
- To identify key factors influencing MVT patient prognosis.
Main Methods:
- Retrospective review of case records for patients diagnosed with primary mesenteric venous thrombosis (MVT) over a 10-year period.
- Data collection included clinical presentation, hypercoagulable states, interventions, and patient outcomes.
Main Results:
- Twenty-eight MVT cases were analyzed (mean age 41.2 years, 19 males), with varying acute, subacute, and chronic presentations.
- Seventeen patients (60%) had identified hypercoagulable states, and 14 (50%) had multiple mesenteric vein involvement.
- Pre-operative diagnosis was achieved in all cases; 10 required initial surgery, while others were managed medically, with 2 later needing surgical intervention.
Conclusions:
- Mesenteric venous thrombosis (MVT) in this cohort frequently involved multiple intra-abdominal vessels and was associated with underlying hypercoagulable conditions.
- A management strategy involving early anticoagulation for all patients and surgical intervention as needed resulted in low mortality.
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