Acute superior mesenteric vein thrombosis. A retrospective study of 9 patients |
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Authors: | Impérato M Moujahid M Mennecier D Béchade D Duverger V Farret O Algayres J-L Baranger B |
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Affiliation: | Service de Chirurgie Viscérale et Vasculaire, H?pital d'Instruction des Armées (HIA) du Val-de-Grace, 74, avenue de Port-Royal, 75005 Paris, France. marc.imperato@wanadoo.fr |
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Abstract: | AIM OF THE STUDY: To determine diagnostic modalities and both immediate and long-term treatment of superior mesenteric venous thrombosis. PATIENTS AND METHODS: Retrospective study from 1997 to 2004 in two institutions concerning patients with superior mesenteric vein thrombosis. RESULTS: Nine patients (all males, mean age=55 years), were included. Abdominal pain (100%), vomiting (44%), and bowel activity disorders (44%) were the most common symptoms. A personal or familial thrombosis history was present in 67% of patients. A genetic predisposing factor of thrombosis was present in 78% of patients. The diagnosis was established with CT-scan in 8 cases with a mean delay of 8 days. Treatment was exclusively medical in 33% of patients and included surgery in 67%. All operated patients underwent resection for bowel infarction and only one had immediate anastomosis. All enterostomies were subsequently closed. No patient died. CONCLUSION: Diagnosis of superior mesenteric vein thrombosis is frequently delayed and relies on CT-scan with intravenous contrast. Prognosis is globally favourable but depends on early application of anticoagulation therapy. In case of surgery, bowel-sparing resection is indicated and enterostomies are often needed. Genetic disorders predisposing to thrombosis are very frequent, that may indicate prolonged even definitive anticoagulation therapy. |
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Keywords: | Mots clés: Douleur abdominale Thrombose veineuse mésentérique Ischémie mésentérique Thrombophilie Résection intestinale Anticoagulants |
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