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Symptomatic visceral arterial thrombosis in a patient with polycythemia vera successfully treated with mesenteric
Yohei Yamamoto1, Kazuki Tsukuda, Ai Kazama
1Division of Vascular Surgery, Department of Cardiovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Rationale:
Polycythemia vera (PV) is a type of myeloproliferative disorder, and thrombosis is one of its important complications. Arterial thrombosis commonly occurs in the coronary and cerebral arteries; however, reports of thrombosis in other arteries are limited, and it is even rarer in visceral arteries.
Patient Concerns:
A 50-year-old woman with PV presented with anorexia and epigastric pain. Detailed history taking revealed a 2-year history of postprandial abdominal pain.
Diagnoses:
Enhanced computed tomography revealed severe stenosis of the celiac artery and thrombotic occlusion of the common hepatic, splenic, and superior mesenteric arteries. The patient was diagnosed with chronic mesenteric ischemia.
Interventions:
The patient underwent an infrarenal aorta-to-superior mesenteric artery bypass using a great saphenous vein graft.
Outcomes:
The postoperative course was uneventful, and her gastrointestinal symptoms resolved completely.
Lessons:
The present case highlights that a patient with PV can develop symptomatic visceral arterial thrombosis. Open mesenteric bypass surgery effectively relieved symptoms.
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