[Acute superior mesenteric vein thrombosis. A retrospective study of 9 patients].
OBJECTIVE
To determine diagnostic modalities and both immediate and long-term treatment of superior mesenteric venous thrombosis.


METHODS
Retrospective study from 1997 to 2004 in two institutions concerning patients with superior mesenteric vein thrombosis.


RESULTS
Nine patients (all males, mean age=55 years), were included. Abdominal pain (100%), vomiting (44%), and bowel activity disorders (44%) were the most common symptoms. A personal or familial thrombosis history was present in 67% of patients. A genetic predisposing factor of thrombosis was present in 78% of patients. The diagnosis was established with CT-scan in 8 cases with a mean delay of 8 days. Treatment was exclusively medical in 33% of patients and included surgery in 67%. All operated patients underwent resection for bowel infarction and only one had immediate anastomosis. All enterostomies were subsequently closed. No patient died.


CONCLUSIONS
Diagnosis of superior mesenteric vein thrombosis is frequently delayed and relies on CT-scan with intravenous contrast. Prognosis is globally favourable but depends on early application of anticoagulation therapy. In case of surgery, bowel-sparing resection is indicated and enterostomies are often needed. Genetic disorders predisposing to thrombosis are very frequent, that may indicate prolonged even definitive anticoagulation therapy.
Impérato
M
M
Service de Chirurgie Viscérale et Vasculaire, Hôpital d'Instruction des Armées (HIA) du Val-de-Grace, 74, avenue de Port-Royal, 75005 Paris, France. marc.imperato@wanadoo.fr
Moujahid
M
M
Mennecier
D
D
Béchade
D
D
Duverger
V
V
Farret
O
O
Algayres
J-L
JL
Baranger
B
B
D015746:Abdominal Pain / Q000175:diagnosis; D004766:Enterostomy; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D006801:Humans; D007238:Infarction / Q000601:surgery; D007410:Intestinal Diseases / Q000175:diagnosis; D007421:Intestine, Small / Q000098:blood supply; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000628:therapy; D008642:Mesenteric Veins / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D014839:Vomiting / Q000175:diagnosis
D005343:Fibrinolytic Agents