[Mesenteric venous thrombosis. A retrospective study of 23 cases].
Mesenteric venous thrombosis is uncommon. Diagnosis is difficult and much remains to be learned about clinical aspects, etiology and treatment options.


METHODS
We conducted a retrospective study over 5 years concerning patients with isolated mesenteric venous thrombosis or with extension to the portal vein.


RESULTS
Twenty-three patients (12 women), mean age 55 years, were included. Abdominal pain (96%), bowel obstruction (35%), fever (26%), diarrhea (17%), gastrointestinal bleeding (13%) were the most common symptoms at presentation. In 78% of patients, at least one underlying condition was identified: thrombophilia, oral contraceptive, cancer, paroxysmal nocturnal hemoglobinuria, essential thrombocythemia, intra-abdominal processes. CT scan and ultrasound diagnostic sensitivity were 89% and 57% respectively. Outcome was favorable for the 18 patients treated with anticoagulants (associated with surgery in 4 patients). Three patients with neoplasm died early.


CONCLUSIONS
Mesenteric venous thrombosis must be kept in mind as a possible diagnosis in patients with abdominal pain. Predisposing factors are frequently associated and should be searched for. Early diagnosis, using CT scan or ultrasound, enables immediate anticoagulation and seems to improve outcome.
Rieu
Virginie
V
Fédération de Médecine Interne, Maladies Infectieuses et Hématologie Clinique., CHRU, Hôtel Dieu, Clermont-Ferrand. virginie_rieu@yahoo.fr
Ruivard
Marc
M
Abergel
Armand
A
Pezet
Denis
D
Fouilhoux
Alain-Charles
AC
Tournilhac
Olivier
O
Philippe
Pierre
P
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D003967:Diarrhea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000628:therapy; D008642:Mesenteric Veins; D008875:Middle Aged; D011169:Portal Vein; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000628:therapy
D000925:Anticoagulants