A retrospective study of diagnosis and management of mesenteric vein thrombosis.
BACKGROUND
Mesenteric vein thrombosis (MVT) is an uncommon type of intestinal ischemia associated with significant mortality and morbidity because of its delay in diagnosis.


METHODS
A retrospective analysis of 9 patients treated surgically for MVT during 1982 to 1997 was performed.


RESULTS
Nine patients underwent surgical therapy for intestinal ischemia due to MVT. The most common presenting symptom was abdominal pain with bloody diarrhea in 3 patients; preoperative diagnosis of MVT was suspected in 2. Radiologic tests included plain roentgenograms, computed axial tomography, and ultrasound. Time to surgery ranged from 3 hours to 7 days after admission. All patients underwent resection of infarcted bowel with primary anastomosis and immediate postoperative anticoagulation. No patient underwent a second-look operation. The postoperative morbidity and mortality rates were 55% and 11%, respectively.


CONCLUSIONS
Diagnosis of intestinal ischemia from MVT is often delayed, and strong clinical suspicion and aggressive treatment are necessary in its management.
Divino
C M
CM
Department of Surgery, Division of Surgical Oncology, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1259, 10029, New York, NY, USA. celia.divino@mountsinai.org
Park
I S
IS
Angel
L P
LP
Ellozy
S
S
Spiegel
R
R
Kim
U
U
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D013927:Thrombosis / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*
D000925:Anticoagulants