title: Mesenteric venous thrombosis in a patient with pancreatitis and protein C deficiency.
abstract: Mesenteric vein thrombosis is an uncommon manifestation of hypercoagulable states. A case is reported of superior mesenteric vein (SMV) thrombosis in a patient with pancreatitis and protein C deficiency. A discussion of SMV thrombosis identification, management, and outcomes is included. The patient presented with a significant history of alcohol abuse and constant, midepigastric abdominal pain associated with nausea and vomiting. Amylase and lipase were elevated, and the patient was treated for pancreatitis. His symptoms initially responded to intravenous fluid hydration, but soon his clinical picture worsened, with increased nausea and vomiting, abdominal pain, and distension. Contrasted computed tomography of the abdomen revealed SMV thrombosis. A hypercoagulable workup revealed protein C deficiency. After a 3-month course of oral anticoagulant therapy, the SMV thrombosis resolved.
authors.affiliation: Department of Medicine and Digestive Disease Center, Medical University of South Carolina, Charleston, SC 29425, USA. rackoff@musc.edu
authors.forename: Andrew
authors.initials: A
authors.lastname: Rackoff
authors.forename: Nathan
authors.initials: N
authors.lastname: Shores
authors.forename: Ira
authors.initials: I
authors.lastname: Willner
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000437:Alcoholism; D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000150:complications*; D020151:Protein C Deficiency / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants