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The management of mesenteric vein thrombosis: a single institution's experience

Fatih Yanar1, Orhan Ağcaoğlu, Ali Fuat Kaan Gök

  • 1Department of General Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey. yanar_fatih@yahoo.com

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|May 31, 2013
PubMed
Abstract

Insights

Mesenteric vein thrombosis (MVT) is rare but serious. Early diagnosis via CT angiography and prompt treatment including anticoagulation and surgical intervention are key for successful management and improved patient outcomes.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Mesenteric vein thrombosis (MVT) is an uncommon cause of acute mesenteric ischemia, accounting for 5-15% of cases.
  • This report details the management of MVT based on a cohort of 34 patients.

Purpose of the Study:

  • To discuss the management strategies for mesenteric vein thrombosis.
  • To evaluate the outcomes of a specific treatment protocol for MVT.

Main Methods:

  • Retrospective analysis of 34 patients diagnosed with acute MVT between January 2007 and January 2010.
  • Diagnostic laparoscopy for peritoneal signs, followed by second-look laparoscopy within 72 hours.
  • Treatment included enoxaparin anticoagulation and follow-up CT angiography at 6 and 12 months to assess venous recanalization.

Main Results:

  • CT angiography identified superior mesenteric vein thrombosis in 73%, portal vein thrombosis in 70%, and splenic vein thrombosis in 35% of patients.
  • Eleven patients with peritoneal signs underwent laparoscopy; eight required small bowel resection and anastomosis.
  • Two patients needed re-resection due to ischemia identified during second-look laparoscopy.

Conclusions:

  • Early diagnosis using CT angiography is crucial for effective MVT management.
  • Successful treatment relies on a combination of surgical/non-surgical revascularization, anticoagulation, and intensive supportive care.

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