Superior mesenteric venous thrombosis after laparoscopic exploration for small bowel obstruction.
Mesenteric venous thrombosis is a rare cause of intestinal ischemia which is potentially life-threatening because it can lead to intestinal infarction. Mesenteric venous thrombosis rarely develops after abdominal surgery and is usually associated with coagulation disorders. Associated symptoms are generally subtle or nonspecific, often resulting in delayed diagnosis. A 68-year-old woman underwent laparoscopic exploration for small bowel obstruction, secondary to adhesions. During the procedure, an intestinal perforation was identified and repaired. Postoperatively, the abdominal pain persisted and repeat exploration was undertaken. At repeat exploration, a perforation was identified in the small bowel with a surrounding abscess. After the second operation, the abdominal pain improved but anorexia persisted. Contrast enhanced abdominal computed tomography was performed which revealed superior mesenteric venous thrombosis. Anticoagulation therapy with heparin was started immediately and the thrombus resolved over the next 6 days. Although rare, this complication must be considered in patients after abdominal surgery with unexplained abdominal symptoms.
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Hideki
H
Katagiri
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Shozo
S
Kunizaki
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Mayu
M
Shimaguchi
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Yasuo
Y
Yoshinaga
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Yukihiro
Y
Kanda
Department of Surgery, Jichi Medical University, 1-3311 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
Alan T
AT
Lefor
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), 3-4-34 Todaijima, Urayasu, Chiba 279-0001, Japan.
Ken
K
Mizokami