Mesenteric and portal vein thrombosis: treated with early initiation of anticoagulation.
OBJECTIVE
Superior mesenteric vein thrombosis (SMVT) is generally difficult to diagnose and can be fatal. Mesenteric and portal vein thrombosis is rare and can be presented as more serious conditions than that of SMVT. We report patients with combined SMVT and portal vein thrombosis (PVT) who were treated successfully with early initiation of anticoagulation.


METHODS
The medical records of six patients (five male, one female) who presented with combined SMVT and PVT in our institute between January 1994 and September 2003 were reviewed retrospectively. All of the patients were treated with early initiation of anticoagulation using unfractionated heparin or low molecular weight heparin.


RESULTS
The mean hospital stay was 31 days and the mean follow-up period was 32 months. Three patients had an antithrombin III deficiency. The most common symptom was diffuse abdominal pain and signs included abdominal distension and tenderness. During the follow-up period, there were two patients who developed stricture of the small bowel necessitating resection and anastomosis of the small bowel. There was no case of peritonitis due to bowel necrosis or mortality.


CONCLUSIONS
The early initiation of anticoagulation in patients of SMVT combined with PVT could minimise the serious complication such as peritonitis due to bowel necrosis required immediate exploratory laparotomy.
Joh
J-H
JH
Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kim
D-I
DI
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D020152:Antithrombin III Deficiency / Q000150:complications; D004932:Esophageal and Gastric Varices; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000601:surgery; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications; D011169:Portal Vein; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy*
D000925:Anticoagulants; D006493:Heparin