[Acute mesenteric venous thrombosis: experience of 27 cases].
OBJECTIVE
To summarize the diagnostic and therapeutic experiences of acute mesenteric venous thrombosis (MVT).


METHODS
The clinical data of 27 cases of acute MVT treated between 1983 and July 2007 were analyzed retrospectively.


RESULTS
The courses of disease were from 1 to 14 days (mean, 6.1 days). Eighteen cases (66.7%) had the history of portal hypertension, deep vein thrombosis, acute MVT or other hypercoagulability. The diagnostic sensitivity of ultrasonography, CT, angiography and serum D-Dimer level were 70.6% (12/17), 75.0% (6/8), 100% (6/6), 100% (6/6), respectively. Bowel necrosis occurred in all the 16 cases with bloody ascites. The thrombolytic and anticoagulation therapy are effective in 36.4% of cases (4/11). Twenty-two cases received operation, and resection of necrotic bowel was performed in all and thrombectomy in 3 cases. The main postoperative complications included 3 cases of deep vein thrombosis, 1 acute cardiac infarction, 3 short bowel syndrome. MVT recurred in 4 cases within a week after operation. Eight patients died within a month after confirmed with acute MVT, in which 7 patients died after operation. Anticoagulation medication was implemented in all the 19 survived patients. Fifteen patients were followed-up for 1-120 months (mean, 39.2 months), 7 of them continued the anticoagulation therapy during this period.


CONCLUSIONS
The determination of serum D-Dimer level and such adjuvant examinations as ultrasonography, CT and angiography are important diagnostic means for acute MVT. Anticoagulation and thrombolysis should be considered firstly if there is no active bleeding and bowel necrosis. We recommend laparotomy when bowel necrosis is suspected.
Cong
Lin
L
Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100730, China.
Yu
Jian-chun
JC
Liu
Chang-wei
CW
Zhang
Tai-ping
TP
Zhao
Yu-pei
YP
Jin
Zheng-yu
ZY
Zhang
Xiao-bo
XB
Lü
Ke
K
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000628:therapy*