medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2011, Number 2

<< Back Next >>

Cir Gen 2011; 33 (2)

Venous mesenteric thrombosis: risk factors, diagnosis, and results of surgical management

Luque-de-León E, Martínez-Ordáz José-Luis, Castellanos G, Ortiz-Maldonado AL, Monter-Carreola GA

Language: Spanish
References: 21
Page: 97-103
PDF size: 165.91 Kb.


ABSTRACT

Objective: To report our experience with patients with mesenteric vein thrombosis managed surgically.
Setting: Third level health care hospital.
Design: Observational, descriptive, retrospective study.
Statistical analysis: Percentages as summary measure for qualitative variables.
Patients and methods: During a 5-year period, eight patients with mesenteric vein thrombosis were managed surgically; five of them had known risk factors for the development of venous thrombosis or had previous events of thrombosis at other sites. Abdominal pain was the predominant symptom, in most cases of three or more days. All had secondary vein thrombosis and required resection of the affected bowel. Six of them survived and were kept on anticoagulation therapy. Two patients died due to pulmonary embolism.
Conclusions: Mesenteric vein thrombosis is a rare entity with vague symptoms. Medical history of the patient, clinical suspicion, and radiological studies are the most important factors for diagnosis; this latter is rarely attained preoperatively. Surgical management with resection of affected bowel leads to acceptable outcomes.


REFERENCES

  1. Kumar S, Sarr M, Kamath PS. Mesenteric venous thrombosis. New Eng J Med 2001; 345: 1683-1688.

  2. Abdu R, Zakhour BJ, Dallis DJ. Mesenteric venous thrombosis--1911 to 1984. Surgery 1987; 101: 383-388.

  3. Rhee RY, Gloviczki P, Mendoza CT, Peterson TM, Serry RD, Sarr MG et al. Mesenteric venous thrombosis: still a lethal disease in the 1990s. J Vasc Surg 1994; 20: 688-697.

  4. Parker HH 3rd, Bynoe RP, Nottingham JM. Thrombosis of the portal venous system after splenectomy for trauma. J Trauma 2003; 54: 193-196.

  5. Morasch MD, Ebaugh JL, Chiou AC, Matsumura JS, Pearce WH, Yao JS Mesenteric venous thrombosis: a changing clinical entity. J Vasc Surg 2001; 34: 680-684.

  6. Eldrup-Jorgensen J, Hawkins RE, Bredenberg CE. Abdominal vascular catastrophes. Surg Clin North Am 1997; 77: 1305-1320.

  7. Sánchez FP, Chávez GJ, Mier y Díaz J, Suárez MRM, Banco BR. Isquemia mesentérica aguda. Análisis retrospectivo de 48 casos. Cir Cir 1997; 65: 39-43.

  8. Mier J, Sánchez P, Blanco R, Rodríguez J, Martínez V. Angiographic and surgical approach to acute mesenteric ischemia. A prospective study. Abstract # 2177 The Society for Surgery of the Alimentary Tract. Fortieth annual meeting 1999; 226: 16-19.

  9. Abu-Daff S, Abu-Daff N, Al-Shahed M. Mesenteric venous thrombosis and factors associated with mortality: a statistical analysis with five-year follow-up. J Gastrointest Surg 2009; 13: 1245-1250.

  10. Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am 1997; 77: 327-338.

  11. Dutta AK, Chacko A, George B, Joseph JA, Nair SC, Matthews V. Risk factors of thrombosis in abdominal veins. World J Gastroenterol 2008; 14(28): 4518-4522.

  12. Bradbury MS, Kavanagh PV, Bechtold RE, Chen MY, Ott DJ, Regan JD, et al. Mesenteric venous thrombosis: diagnosis and non-invasive imaging. Radiographics 2002; 22: 527-541.

  13. Divino CM, Park IS, Angel LP, Ellozy S, Spiegel R, Kim U. A retrospective study of diagnosis and management of mesenteric vein thrombosis. Am J Surg 2001; 181: 20-23.

  14. Acosta S, Alhadad A, Svensson P, Eckberg O. Epidemiology, risk and prognostic factors in mesenteric venous thrombosis. Br J Surg 2008; 95(10): 1245-1251.

  15. Kumar S, Kamath PS. Acute superior mesenteric venous thrombosis: one disease or two. Am J Gastroenterol 2003; 98: 1299-1304.

  16. Poplausky MR, Kaufman JA, Geller SC, Waltman AC. Mesenteric venous thrombosis treated with urokinase via the superior mesenteric artery. Gastroenterology 1996; 110: 1633-1635.

  17. Train JS, Ross H, Weiss JD, Feingold MR, Khoury-Yacoub A, Khoury PT. Mesenteric venous thrombosis; successful treatment by intra-arterial lytic therapy. J Vasc Interv Radiol 1998; 9: 461-464.

  18. Grisham A, Lohr J, Guenther JM, Engel AM. Deciphering mesenteric venous thrombosis: imaging and treatment. Vasc Endovascular Surg 2005; 39(6): 473-479.

  19. Lui GA, Poniachik TJ, Quera PR, Bermudez EC. Mesenteric vein thrombosis: clinical manifestations, treatment and outcome. Rev Med Chil 2005; 133: 17-22.

  20. Sánchez-Fernández P, Mier y Díaz J, Blanco-Benavides R. Isquemia mesentérica aguda. Semblanza de una enfermedad agresiva. Rev Gastroenterol Mex 2000; 65: 134-40.

  21. Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg 2004; 91: 17-27.




2020     |     www.medigraphic.com