title: The management of mesenteric vein thrombosis: a single institution's experience.
abstract: BACKGROUND
  Mesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients.
  
  
  METHODS
  In the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins.
  
  
  RESULTS
  CT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed.
  
  
  CONCLUSIONS
  Early diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.
authors.affiliation: Department of General Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey. yanar_fatih@yahoo.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Yanar
authors.forename: Orhan
authors.initials: O
authors.lastname: Ağcaoğlu
authors.forename: Ali Fuat Kaan
authors.initials: AF
authors.lastname: Gök
authors.forename: Inanç Samil
authors.initials: IS
authors.lastname: Sarıcı
authors.forename: Beyza
authors.initials: B
authors.lastname: Ozçınar
authors.forename: Nihat
authors.initials: N
authors.lastname: Aksakal
authors.forename: Murat
authors.initials: M
authors.lastname: Aksoy
authors.forename: Enver
authors.initials: E
authors.lastname: Ozkurt
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kurtoğlu
mesh_terms: D000006:Abdomen, Acute; D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D017984:Enoxaparin / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents