title: Mesenteric ischemia and protein S deficiency: a rare case report.
abstract: We present an unusual case of a 31-year-old nulliparous woman who was in her normal state of health until 3 weeks before her Emergency Department visit, when she began to have generalized abdominal pain that got acutely worse over a few days. She had a soft abdomen, but complained of excruciating pain. Her computed tomography (CT) scan revealed thrombosis in the superior mesenteric, splenic, and portal veins. Her hematological work-up detected a protein S deficiency, which is associated with recurrent venous thrombosis. The finding of mesenteric venous thrombosis associated with protein S deficiency is rare. The most important factor in survival is early diagnosis and prompt treatment with anticoagulants. Properly treated, patients with mesenteric venous thrombosis should have a good long-term prognosis. Past medical or family history of thrombosis in combination with abdominal symptoms should increase the suspicion for the disease.
authors.affiliation: Department of Emergency Medicine and Radiology, North Shore University Hospital, Manhasset, New York 11030, USA.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Llovera
authors.forename: Zhanna
authors.initials: Z
authors.lastname: Roit
authors.forename: Shadi
authors.initials: S
authors.lastname: Kiriaki
authors.forename: Andrew
authors.initials: A
authors.lastname: Sama
authors.forename: John
authors.initials: J
authors.lastname: Loscalzo
authors.forename: Nikhil
authors.initials: N
authors.lastname: Goyal
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D008642:Mesenteric Veins; D011169:Portal Vein; D011379:Prognosis; D018455:Protein S Deficiency / Q000150:complications*; D013162:Splenic Vein; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D014859:Warfarin