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[Mesenteric vein infarction associated with congenital antithrombin III (ATIII) deficiency]
Y M Guillou1, J P Bleichner, F Gobron
1Réanimation Chirurgicale, CHRU Pontchaillou, Rennes.
Abstract:
A venous mesenteric infarction in a 27-year-old patient is reported. This patient presented a genetic quantitative AT-III deficiency without anticoagulation therapy. Ultrasonography revealed portal vein thrombosis and laparoscopy showed mesenteric vein infarction. Laparotomy was performed mmediately and revealed segmental infarction of 60 cm of the jejunum which was resected; the portal vein was considered to be partially occluded on palpation. No strangulation or mechanical factors were identified. Immediately postoperatively the patient received therapeutic doses of heparin with AT-III concentrates to increase AT-III levels; no recurrent thrombotic episode was observed. A systematic second-look operation 24 hours postoperatively showed good bowel viability. Five days later, long-term anticoagulation with acenocoumarol was decided. Twelve days later, ultrasonography showed complete portal revascularization which was confirmed by a third surgical operation on D60.
Insights
A young patient with genetic antithrombin-III deficiency experienced mesenteric infarction and portal vein thrombosis. Treatment involved surgery, heparin, and antithrombin-III concentrates, leading to successful recovery and portal vein revascularization.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Hematology
Background:
- Mesenteric infarction is a rare but serious condition, often associated with thrombotic disorders.
- Genetic antithrombin-III (AT-III) deficiency is an inherited risk factor for venous thromboembolism.
- This case highlights a young patient with undiagnosed AT-III deficiency presenting with severe mesenteric and portal vein thrombosis.