[Mesenteric arterial thrombosis in protein S deficiency].
Arterial thrombosis is very rarely described in patients with coagulation factors deficiency. We report the first case of superior mesenteric artery thrombosis of a normal mesenteric artery associated with protein S deficiency, causing massive mesenteric infarction with short bowel syndrome. Eight-month parenteral nutrition and definitive antivitamin K anticoagulation were required in this 72 year-old patient. The initial oral anticoagulant malabsorption disappeared a few months later as clinical and biological course improved. Rapid intestinal adaptation was probably consecutive to early enteral refeeding. The possibility of reintroducing antivitamin K despite initial inefficacy should be stressed, as well as the necessity of an exhaustive coagulation work-up in patients with mesenteric infarction.
Dreyfus
G
G
Service de Gastroentérologie et Nutrition, Hôpital de L'Archet, Nice.
Peroux
J L
JL
Hébuterne
X
X
Legoff
D
D
Rampal
P
P
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D004750:Enteral Nutrition; D006801:Humans; D007238:Infarction / Q000209:etiology; D007422:Intestines / Q000098:blood supply; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000209:etiology* / Q000628:therapy; D018455:Protein S Deficiency / Q000150:complications*; D011859:Radiography; D012778:Short Bowel Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013927:Thrombosis / Q000209:etiology*
D000925:Anticoagulants