PRIMARY MESENTERIC VENOUS THROMBOSIS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 154  (2) , 205-208
Abstract
Optimal management and ultimate outcome of patients with primary mesenteric venous thrombosis were studied. The records of 9 such patients were analyzed. There were 7 male and 2 female patients, with a mean age of 47 yr. No one of the laboratory findings were specifically diagnostic for mesenteric venous thrombosis, but leukocytosis and hemoconcentration were commonly found. Roentgenographic findings were consistent with intestinal obstruction in 6 patients. Thrombosis of the mesenteric veins could not be attributed to any specific cause in these 9 patients, thereby warranting the classification of primary. At operation, all 9 patients had a segment of infarcted small intestine (132 .+-. 105 cm) with obvious thrombosis of the mesenteric veins but with patient mesenteric arteries. Five patients had bloody ascites. Two deaths occurred in the immediate postoperative period, both being due to sudden and unexpected cardiopulmonary arrest. Neither of these 2 patients received anticoagulant therapy. Two patients had undergone segmental resection at other hospitals and were referred to this institution because of a recurrence of acute abdominal signs and symptoms. Neither of these patients received anticoagulant therapy. At reoperation, both had recurrent segmental mesenteric venous thrombosis. Familiarity with this condition is essential in making the correct diagnosis, so that resection may be undertaken promptly. Heparin should immediately be administered i.v. after establishing the diagnosis of mesenteric venous thrombosis to prevent recurrent thrombosis and other possible thrombotic complications. If these steps are taken expeditiously, the prognosis of mesenteric venous thrombosis is often favorable.

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