ACUTE MESENTERIC VENOUS THROMBOSIS SIMULATING ACUTE PANCREATITIS

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Abstract
The clinical diagnosis of mesenteric venous thrombosis is often difficult to establish. The following case was incorrectly diagnosed as acute pancreatitis. Several diagnostic peritoneal taps were done during the patient's hospitalization, and in retrospect the gross findings and elevated amylase levels were more suggestive of mesenteric thrombosis than of acute pancreatitis. We hope that this case report will encourage the more widespread use of peritoneal tap as a diagnostic adjunct in cases of obscure abdominal disease. Report of a Case At his first admission to the Peter Bent Brigham Hospital, a 63-year-old man had the chief complaint of abdominal pain of two days' duration. Three weeks prior to admission the patient first noted mild constipation, which responded to laxatives and cathartics; three days prior to admission he gradually developed steady periumbilical and lower abdominal pain, which radiated to the middle part of the back. There were occasional cramp-like exacerbations of

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