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Mesenteric venous thrombosis

R Y Rhee1, P Gloviczki

  • 1Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.

The Surgical Clinics of North America
|April 1, 1997
PubMed
Summary

Mesenteric venous thrombosis (MVT) is a rare cause of visceral ischemia with nonspecific symptoms. Early diagnosis with CT or MRI and prompt anticoagulation are crucial for managing MVT patients.

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Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Mesenteric venous thrombosis (MVT) is an uncommon cause of visceral ischemia.
  • Clinical presentation of MVT is often nonspecific, hindering timely diagnosis.
  • High mortality rates associated with acute MVT necessitate improved diagnostic and management strategies.

Purpose of the Study:

  • To outline a diagnostic algorithm for suspected MVT.
  • To detail management strategies for acute and chronic MVT.
  • To emphasize the importance of early diagnosis and anticoagulation in MVT.

Main Methods:

  • Review of diagnostic approaches including CT and MRI.
  • Description of surgical interventions for ischemic bowel.
  • Discussion of anticoagulation protocols (heparin and warfarin).

Main Results:

  • CT or MRI are the most sensitive tests for MVT diagnosis.
  • Prompt anticoagulation with heparin is indicated upon diagnosis.
  • Surgical resection of nonviable bowel may be required, with fluorescein-assisted evaluation recommended.

Conclusions:

  • A simple diagnostic algorithm and early imaging are key for MVT management.
  • Lifelong anticoagulation is recommended for patients with MVT.
  • Despite advances, MVT, particularly the acute form, has a high mortality and recurrence rate.

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