title: Clinical and radiographic presentation of superior mesenteric vein thrombosis in Crohn's disease: a single center experience.
abstract: BACKGROUND
  Mesenteric vein thrombosis (MVT) is a rare and frequently underdiagnosed complication of Crohn's disease (CD). This study describes the clinical and radiological characteristics of CD /patients with superior mesenteric vein thrombosis (MVT) diagnosed by CT/MRI.
  
  
  METHODS
  The database of Crohn's disease patients treated in Sheba Medical Center between 2005-2010 was searched for MVT diagnosis. Imaging studies of identified patients were retrieved and reviewed by an experienced abdominal radiologist. MVT was defined by superior mesenteric vein obliteration and/or thrombus in the vessel lumen on abdominal imaging. The clinical and radiologic data of these patients were collected from the medical records.
  
  
  RESULTS
  MVT was demonstrated in 6/460 CD patients. Five patients had stricturing disease, and one patient had a combined fistulizing and stricturing disease phenotype. All patients had small bowel disease, but 3/6 also had colonic involvement. No patient had a prior thromboembolic history or demonstrable hypercoagulability. One patient had an acute SMV thrombus demonstrable on CT scanning, the remaining patients showed an obliteration of superior mesenteric vein. Two patients received anticoagulation upon diagnosis of thrombosis. No subsequent thromboembolic events were recorded.
  
  
  CONCLUSIONS
  The incidence of mesenteric vein thrombosis is likely to be underestimated in patients with Crohn's disease. Both CT and MRI imaging demonstrate the extent of enteric disease and coincident SMV thrombosis. In our cohort, thrombosis was associated with stricturing disease of the small bowel. The clinical impact of SMV thrombosis and whether anticoagulation is mandatory for all of these patients remains to be determined.
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Israel. ukopylov@gmail.com
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Amitai
authors.forename: Aharon
authors.initials: A
authors.lastname: Lubetsky
authors.forename: Rami
authors.initials: R
authors.lastname: Eliakim
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
mesh_terms: D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000209:etiology; D008642:Mesenteric Veins; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult