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Ulus Travma Acil Cerrahi Derg. 2013 May;19(3):223-8. doi: 10.5505/tjtes.2013.47542.

The management of mesenteric vein thrombosis: a single institution's experience.

Author information

1
Department of General Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey. yanar_fatih@yahoo.com

Abstract

BACKGROUND:

Mesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients.

METHODS:

In the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins.

RESULTS:

CT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed.

CONCLUSION:

Early diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.

PMID:
23720109
DOI:
10.5505/tjtes.2013.47542
[Indexed for MEDLINE]
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