Superior mesenteric venous thrombosis: a retrospective study of thirteen cases

Abstract

Objective: to analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT) at an university hospital in Madrid. Experimental design: retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software. Patients: all thirteen subjects diagnosed with SMVT in that period were included. Results: associated risk factors included tumoral conditions (5 patients), acute abdominal pathology (2), polyglobulia (1), prothrombin gene mutation (1), and anticardiolipin antibodies (1). No predisposing factor was found in 3 patients. Clinical presentation for all patients was abdominal pain, with nausea and vomiting being the second symptom in frequency (7). The diagnosis was reached by abdominal CT (9), arteriography (2), ultrasounds (1), and histology after intestinal resection (1). Treatment with only anticoagulation was initiated in 4 patients, whereas anticoagulation and surgery were performed in 5 cases. In 4 subjects no specific treatment was prescribed and only palliative measures were established due to a baseline end-stage condition. Five patients died, and four of them had a neoplasic condition as associated risk factor. Mortality in our series was 38.5%. Conclusions: SMVT is a very rare disease that is often associated with neoplasic pathology, which influences its high mortality. Due to non specific symptoms, imaging is essential for the diagnosis and the detection of associated risk factors. In our series, computed tomography imaging was the most profitable test.

Clinical Presentation and Outcome of Mesenteric Vein Thrombosis

“…29 Historically, the mortality rate of MVT ranged from 7% to 38.5% (Table 5). 2,[4][5][6]10,11,16,23,[30][31][32] The overall mortality rate in the present study was 17% (83% were males), which is similar to the mortality rate (18%) observed by Rieu et al from France 32 and greater than for the Abu-Daff series (13%) from Saudi Arabia. 10 The overall survival in patients with MVT relies heavily on various factors, particularly age, associated predisposing factors, early diagnosis, anticoagulation, and surgical management.…”

“…1 Patients with MVT commonly present with complaints of nausea, vomiting, anorexia, and diarrhea together with abdominal discomfort. 4 Development of hypercoagulable state is a key manifestation of MVT, which might evolve due to intra-abdominal inflammation, a postoperative condition, portal hypertension, cirrhosis, cancer, or other coagulation disorders. 1 Use of oral contraceptive among young women is also associated with an increased risk of MVT.…”

“…However, overall mortality among patients with MVT is high and ranges from 7% to 38%. 4,5 In general, treatment of MVT depends on the underlying cause and severity and it aims to prevent or halt bowel infarction. 6,9 Herein, we evaluate the etiology, clinical presentation, management, and outcome of MVT in Qatar.…”

Multidisciplinary Stepwise Management Strategy for Acute Superior Mesenteric Venous Thrombosis: An Intestinal Stroke Center Experience

“…Our findings are accordant to other reports in terms of clinical presentations and anatomic site of involvement. The most common site is ileum, followed by jejunum and colon [24,25]. Underlying thrombophilia often leads to small-vessel MVT beginning from intramural venules, vasa recta and venous arcades.…”

Trombose de veia mesentérica superior: relato de caso

“…A não especificidade dos sintomas, faz com que o diagnostico seja retardado. Um alto índice de suspeita, o diagnostico precoce com a ajuda de técnicas modernas de diagnóstico (ultra-som, tomografia computadorizada abdominal), precoce e tratamento com anticoagulação e cirurgia, se necessário, ajuda a melhorar a sobrevivência e evitar recorrências 6 .…”