Cytomegalovirus-associated superior mesenteric vein  thrombosis treated with systemic and in-situ thrombolysis.
A 56-year-old patient, first diagnosed with an acute cytomegalovirus infection, presented with progressive abdominal pain because of a superior mesenteric vein thrombosis for which he was treated with systemic thrombolysis and heparin in continuous infusion. As this therapy did not have the intended success after 5 days, an interventional radiological procedure was performed with local thrombolysis in the superior mesenteric artery resulting in recanalisation of the vein. Oral anticoagulation was initiated and continued for a period of 6 months. Mesenteric venous thrombosis is a relatively uncommon cause of mesenteric ischemia that can be associated with severe morbidity and significant mortality. With noninvasive techniques, it is possible to establish a diagnosis in the majority of the cases. The importance of an early diagnosis and therapy - not only with anticoagulation, but also thrombolysis in selected cases - is shown with this case and review of the literature.
Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium. wouter.vanmoerkercke@scarlet.be
Wouter
W
Van Moerkercke
Karen
K
Pauwelyn
Eddy
E
Brugman
Marc
M
Verhamme
D003586:Cytomegalovirus Infections / Q000150:complications*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy / Q000821:virology*; D008642:Mesenteric Veins; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D020246:Venous Thrombosis / Q000188:drug therapy / Q000821:virology*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator