Role of diagnostic laparoscopy in managing acute mesenteric venous thrombosis.
We describe two cases with acute mesenteric venous thrombosis in which diagnostic laparoscopy helped to diagnose the possible bowel infarction. These patients presented with abdominal pain out of proportion to physical findings, and computed tomography demonstrated thrombus in the superior mesenteric vein. Anticoagulation with heparin followed by diagnostic laparoscopy was done immediately after the diagnosis was established. According to the laparoscopic findings, one was managed with full anticoagulation without laparotomy and the other was managed with full anticoagulation and surgical resection. Considering that delay in diagnosis and surgical exploration is still frequent and is a significant contributory factor to the reported high mortality rate, diagnostic laparoscopy in an early position in the management algorithm for acute mesenteric venous thrombosis can furnish a rapid precise diagnosis of bowel infarction. It can also reduce the unnecessary laparotomies in these difficult cases.
Cho
Yong Pil
YP
Department of Surgery, University of Ulsan Medical College, Gangneung Asan Hospital, Gangneung-si, Gangwon-do, Republic of Korea. ypcho@knh.co.kr
Jung
Seung Mun
SM
Han
Myoung Sik
MS
Jang
Hyuk Jai
HJ
Kim
Jee Soo
JS
Kim
Yong Ho
YH
Lee
Sung Gyu
SG
D000208:Acute Disease; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*