Superior mesenteric vein thrombosis after the Whipple procedure: an aggressive, combined treatment approach.
It is now recognized that occlusion of the mesenteric veins not only may complicate a number of disease processes but may occur as a life-threatening complication after abdominal surgery. A 32-year-old woman had mesenteric venous thrombosis after resection of a duodenal inflammatory pseudotumour by pancreatoduodenectomy. She recovered fully after treatment, which consisted of thrombectomy, flushing with urokinase and intravenous administration of heparin. Papaverine infused for 4 days substantially improved bowel viability. Current concepts in mesenteric vein occlusion and the principles of clinical management are reviewed.
Sanabria
J R
JR
Department of Surgery, Mount Sinai Hospital, University of Toronto, Ont.
Hiruki
T
T
Szalay
D A
DA
Tandan
V
V
Gallinger
S
S
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008641:Mesenteric Vascular Occlusion / Q000209:etiology* / Q000628:therapy; D008642:Mesenteric Veins; D016577:Pancreaticoduodenectomy; D010960:Plasminogen Activators / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology* / Q000628:therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D006493:Heparin; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator