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Mesenteric venous thrombosis complicating acute appendicitis: A case series
Jason Beckermann1, Ashley Walker1, Bradley Grewe2
1Department of General Surgery, Mayo Clinic Health System, Eau Claire, WI, USA; University of Wisconsin-Eau Claire, Eau Claire, WI, USA.
International Journal of Surgery Case Reports
|July 12, 2020
Summary
Mesenteric venous thrombosis complicating acute appendicitis is a rare condition. This study found an incidence of 0.25% in appendicitis patients, with delayed presentation and initial management involving heparin, antibiotics, and fluids.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Abdominal Imaging
Background:
- Acute appendicitis is a common surgical emergency.
- Mesenteric venous thrombosis (MVT) is a rare complication of acute appendicitis.
- This study focuses on the rare presentation of MVT in appendicitis patients.
Purpose of the Study:
- To investigate the incidence and characteristics of mesenteric venous thrombosis in patients with acute appendicitis.
- To describe the demographic data, presentation findings, and management patterns of these patients.
Main Methods:
- Retrospective review of the Mayo Enterprise clinical database.
- Inclusion criteria: inpatients with acute appendicitis and venous thrombosis ICD-10 codes.
- Chart review for demographic data, presentation, and management of MVT and appendicitis cases.
Main Results:
- Identified 1,615 inpatients with acute appendicitis; 4 also had MVT (0.25% incidence).
- Mean symptom duration at presentation was 12.25 days.
- All patients received heparin, antibiotics, and IV fluids; 3 of 4 underwent appendectomy.
Conclusions:
- Mesenteric venous thrombosis complicating acute appendicitis is rare and often presents late.
- Initial management for patients without non-viable bowel includes IV fluids, antibiotics, bowel rest, and heparin anticoagulation.
- Surgical intervention like appendectomy may be necessary.
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