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Mesenteric venous thrombosis.

T R Harward1, D Green, J J Bergan

  • 1Department of Surgery, Northwestern University Medical School, Chicago, Ill.

Journal of Vascular Surgery
|February 1, 1989
PubMed
Summary
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Mesenteric venous thrombosis, a serious condition, often presents with abdominal pain and can be linked to clotting disorders. Early diagnosis is key, especially in patients with a history of deep vein thrombosis.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Hematology

Background:

  • Mesenteric venous thrombosis (MVT) is a rare but serious condition.
  • It can lead to significant morbidity and mortality if not diagnosed and treated promptly.
  • Risk factors include coagulopathies and prior thrombotic events.

Purpose of the Study:

  • To review the clinical presentation, diagnostic methods, and outcomes of patients with MVT.
  • To identify key indicators for suspecting MVT in clinical practice.

Main Methods:

  • Retrospective review of 16 patients diagnosed with MVT between 1983 and 1987.
  • Analysis of clinical symptoms, diagnostic imaging (CT scan, arteriography), surgical findings, and laboratory results for coagulopathies.
  • Review of patient outcomes and treatment strategies.

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Main Results:

  • Common symptoms included abdominal pain, gastrointestinal bleeding, and malaise.
  • Computerized tomographic (CT) scans were crucial for diagnosing superior mesenteric vein thrombosis (SMVT) and portal vein thrombosis.
  • Nine patients (56%) had identifiable coagulopathies, including protein C, protein S, and factor IX deficiencies.
  • Five patients required surgical exploration and bowel resection; two died of intestinal necrosis.

Conclusions:

  • Mesenteric venous thrombosis can occur without bowel gangrene.
  • Diagnosis should be considered in patients presenting with acute abdominal symptoms, especially those with a history of thrombotic episodes and known coagulopathies.
  • Prompt diagnosis and management are critical for improving patient outcomes.