Mesenteric venous thrombosis due to antithrombin III deficiency

Area of Science:

• Vascular pathology
• Gastroenterology
• Hematology

Background:

• A 19-year-old woman presented with acute abdominal pain, peritonitis, and hematemesis.
• Her medical history included recurrent deep vein thrombosis (DVT) associated with oral contraceptive use.

Observation:

• Laparotomy revealed segmental small-bowel infarction secondary to mesenteric vein thrombosis.
• The patient's father died young from mesenteric and portal vein thrombosis.

Findings:

• Antithrombin III deficiency, a primary thrombotic disorder, was identified as the underlying cause.
• The patient experienced a fatal hemorrhagic cerebral infarction before anticoagulant therapy could commence.

Implications:

• This case highlights the critical importance of considering inherited thrombotic disorders in young patients with unexplained venous thrombosis.
• Early diagnosis and management of thrombophilia are crucial to prevent catastrophic thromboembolic events, including mesenteric ischemia and cerebral infarction.