Acute mesenteric venous thrombosis: Case for nonoperative management

Abstract

Nonoperative management for acute MVT is feasible when the initial diagnosis with a computed tomography scan is certain and when the bowel infarction has not led to transmural necrosis and bowel perforation. The morbidity, mortality, and survival rates are similar in cases of surgical and nonoperative management. The length of hospital stay is shorter when patients are treated with a nonoperative approach. A nonoperative approach, when indicated, avoids the resection of macroscopically infarcted small bowel (without transmural necrosis) in cases that are potentially reversible with anticoagulation alone.

The Management of Mesenteric Vein Thrombosis: A Single Institution Experience

“…A non-operative approach to anticoagulation can be successful in more than 90% of patients. [26] In some studies, thrombolysis and endovascular treatments were attempted in patients diagnosed with MVT and clinical success was reported. [27][28][29][30][31][32] However, there have been no randomized control trials to provide more certain evidence of the effectiveness of these procedures.…”

Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis

“…In our study, all patients had anticoagulation treatment with a combination of urokinase and heparin sodium. The prevalence of hemorrhage is high (23%-28%) [21,[35][36][37][38] . Therefore, an emergency treatment including ECG monitoring and blood pressure control for bleeding must be prepared.…”

Laparoscopic-assisted Resection for Jejunal Stenosis Following Extensive Portomesenteric Venous Thrombosis

“…1 However, with advances in diagnostic imaging modalities and treatment, an increasing number of cases of PMVT successfully treated with conservative therapy have been reported. [2][3][4] It is very important to establish a strategy for the efficient management of late sequelae occurring after successful conservative treatment of this condition. Ischemic bowel stenosis is one of the most frequent late sequelae of PMVT.…”

“…The initial treatment strategy for MVT has recently tended toward the use of conservative methods before surgical intervention, and most patients can be successfully treated in this way. [2][3][4] In rare cases, however, bowel strictures may develop, owing to chronic ischemia.…”