Hypercoagulable Factors Attributing to Superior Mesenteric Vein Thrombosis and Acute Mesenteric Ischemia

Abstract

Acute mesenteric ischemia is rare and can be difficult to diagnose due to vague symptoms often endorsed by patients. It can be fatal if not discovered in time, as it can lead to bowel ischemia, sepsis, and ultimately death. Here, we present a case of a 23-year-old female with hepatic steatosis, obesity, and 5-year history of birth control use who developed acute mesenteric ischemia secondary to superior mesenteric venous (SMV) thrombosis, requiring small bowel resection of 238 cm out of 480 cm (49.5%) after delay in diagnosis. Hypercoagulable and genetic workup during admission later revealed heterozygous factor V Leiden (FVL) mutation. The patient was ultimately discharged to inpatient rehabilitation on anticoagulation.

Case report: Management of liver cancer complicated by gastric varices rupture and bleeding: transjugular intrahepatic portosystemic shunt utilizing the mesenteric venous pathway

“…Immediate local contrast imaging revealed some thrombus formation in the mesenteric veins ( Figure 1F ). In this study, several factors were identified to be increasing the likelihood of acute mesenteric venous thrombosis (MVT), including smoking, high blood pressure, peritonitis, hemoglobin levels, albumin levels, intraperitoneal free fluid, decreased intestinal wall enhancement, and bowel distension ( 28 ). Additionally, factors such as a history of blood clotting problems, splenectomy, and symptoms like nausea, vomiting, abdominal pain, tenderness, and distension, along with lab results showing high plasma lactate levels and white blood cell counts, must be considered ( 29 ).…”