Superior Mesenteric Vein Thrombosis: Computed Tomography Diagnosis

Desai, Shashank; Cox, Michael R.; Martín, Christopher J.

doi:10.1111/j.1445-2197.1998.tb04688.x

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Because of these drawbacks, the American Gastrointestinal Association [49] concluded that CT is of limited use in the diagnosis of AMI and that unremarkable CT findings in the context of a high suspicion of mesenteric ischemia should prompt an angiography without delay. An exception to this rule is when superior mesenteric vein thrombosis is suspected; a situation where CT scan remains the test of choice with sensitivity rate in the range of 90% [14,50] . Recently, the multi-detector row CT has emerged as a widely established non-invasive technique that not only delineates the blood vessels, but also shows an anatomical three dimensional relationship with the surrounding tissues, and allows evaluation of tissue perfusion [58] .…”

Section: Imaging Studiesmentioning

confidence: 99%

“…The sensitivity and specificity are 74% to 100% and 100%, respectively [49] . When used in the absence of peritonitis signs, angiography has been shown to improve the survival rate [50,51] . Mesenteric angiography can usually identify the underlying pathophysiologic event, by differentiating between embolic and thrombotic occlusion [52] .…”

Section: Imaging Studiesmentioning

confidence: 99%

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Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, is the only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

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Section: Imaging Studiesmentioning

confidence: 99%

Section: Imaging Studiesmentioning

confidence: 99%

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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“…Elle permet aussi de préciser les limites de la thrombose, de montrer une éventuelle extension aux veines collatérales, de rechercher une présence d'air dans le système porte ou la veine mésentérique ainsi que d’écarter une autre maladie à l'origine de la symptomatologie digestive [10]. L’échographie doppler aurait une bonne sensibilité pour la détection du thrombus ou d'une anomalie de flux dans la veine mésentérique mais il requiert un échographiste expérimenté et la rentabilité est moindre que celle de la tomodensitométrie [3, 13]. Il constitue un bon examen pour la surveillance de la reperméabilisation du système porte.…”

Section: Discussionunclassified

Thrombose veineuse mésentérique supérieure compliquant une appendicite méconnue

Barni¹,

Kharras²,

Lahkim³

et al. 2013

Pan Afr Med J

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La thrombose veineuse mésentérique supérieure (TVMS) peut se présenter selon un mode aigu, subaigu ou chronique. Réputée rare, elle peut être primitive ou secondaire. Les étiologies chirurgicales les plus fréquemment identifiées de TVMS sont la diverticulite colique et l'appendicite aiguë. Les auteurs ont jugé utile de rapporter une observation de TVMS compliquant une appendicite refroidie par les antibiotiques, tout en insistant sur la latence clinique de telle pathologie rendant son diagnostic et son traitement plus difficile.

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“…Cela explique en partie que dans le passé, le diagnostic était fait par laparotomie dans plus de 90 % des cas [4]. De nos jours, la tomodensitométrie abdominale semble être l'examen de choix avec une sensibilité supérieure à 90 % [17,18,20]. Dans notre étude, cette sensibilité est de 100 % car tous les patients avaient tous les signes directs et indirects de TVMS mais il s'agit d'une étude rétrospective.…”

Section: Discussionunclassified