Acute mesenteric venous thrombosis: Improved outcome with early diagnosis and prompt anticoagulation therapy

Mesenteric venous thrombosis is a rare cause of intestinal ischemia which is potentially life-threatening because it can lead to intestinal infarction. Mesenteric venous thrombosis rarely develops after abdominal surgery and is usually associated with coagulation disorders. Associated symptoms are generally subtle or nonspecific, often resulting in delayed diagnosis. A 68-year-old woman underwent laparoscopic exploration for small bowel obstruction, secondary to adhesions. During the procedure, an intestinal perforation was identified and repaired. Postoperatively, the abdominal pain persisted and repeat exploration was undertaken. At repeat exploration, a perforation was identified in the small bowel with a surrounding abscess. After the second operation, the abdominal pain improved but anorexia persisted. Contrast enhanced abdominal computed tomography was performed which revealed superior mesenteric venous thrombosis. Anticoagulation therapy with heparin was started immediately and the thrombus resolved over the next 6 days. Although rare, this complication must be considered in patients after abdominal surgery with unexplained abdominal symptoms.

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Anticoagulation therapy dramatically improved severe sigmoiditis with findings resembling inflammatory bowel disease, which was caused by mesenteric venous thrombosis

Clinical Journal of Gastroenterology ◽

10.1007/s12328-012-0340-3 ◽

2012 ◽

Vol 5 (6) ◽

pp. 377-382

Author(s):

Yohei Mikami ◽

Takanori Kanai ◽

Eisuke Iwasaki ◽

Makoto Naganuma ◽

Yoshiyuki Yamagishi ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Venous Thrombosis ◽

Bowel Disease ◽

Anticoagulation Therapy ◽

Mesenteric Venous Thrombosis ◽

Inflammatory Bowel

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GW27-e1195 Early diagnosis of acute superior mesenteric venous thrombosis in emergency department: a case report and review of the literatures

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2016.07.669 ◽

2016 ◽

Vol 68 (16) ◽

pp. C177

Author(s):

Huang Yingxiong ◽

Ye Zi ◽

Zheng Zi-yu ◽

Jiang Peng ◽

Chang Guang-qi ◽

...

Keyword(s):

Emergency Department ◽

Case Report ◽

Early Diagnosis ◽

Venous Thrombosis ◽

Mesenteric Venous Thrombosis

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Acute Mesenteric Venous Thrombosis: A Better Outcome Achieved Through Improved Imaging Techniques and a Changed Policy of Clinical Management

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70269-0 ◽

2006 ◽

Vol 2006 ◽

pp. 350-351

Author(s):

G.L. Moneta

Keyword(s):

Venous Thrombosis ◽

Clinical Management ◽

Imaging Techniques ◽

Mesenteric Venous Thrombosis

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CT diagnosis of traumatic mesenteric venous thrombosis.

American Journal of Roentgenology ◽

10.2214/ajr.154.2.2105044 ◽

1990 ◽

Vol 154 (2) ◽

pp. 425-425 ◽

Cited By ~ 1

Author(s):

M D Salerno ◽

B S Rose

Keyword(s):

Venous Thrombosis ◽

Mesenteric Venous Thrombosis ◽

Ct Diagnosis

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A systematic review and meta-analysis on endovascular treatment as an attractive alternative for acute superior mesenteric venous thrombosis

Vascular ◽

10.1177/1708538121991270 ◽

2021 ◽

pp. 170853812199127

Author(s):

Lixin Wang ◽

Enci Wang ◽

Fei Liu ◽

Wei Zhang ◽

Xiaolong Shu ◽

...

Keyword(s):

Systematic Review ◽

Treatment Group ◽

Conservative Treatment ◽

Venous Thrombosis ◽

Endovascular Treatment ◽

Meta Analysis ◽

Statistical Significance ◽

Published Data ◽

Mesenteric Venous Thrombosis ◽

Surgery Group

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

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