• Fatih Yanar, Orhan Ağcaoğlu, Ali Fuat Kaan Gök, Inanç Samil Sarıcı, Beyza Ozçınar, Nihat Aksakal, Murat Aksoy, Enver Ozkurt, and Mehmet Kurtoğlu.
• Department of General Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey. yanar_fatih@yahoo.com
• Ulus Travma Acil Cer. 2013 May 1;19(3):223-8.

BackgroundMesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients.MethodsIn the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins.ResultsCT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed.ConclusionEarly diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.

23 keywords...

hide…