TWO CASES OF SUPERIOR MESENTERIC VEIN THROMBOSIS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 65; no. 8; pp. 2231 - 2236
• Main Authors: TAKAHASHI, Akira, HARADA, Naoki, ISHII, Noboru, NAKAMURA, Masahiko, TOYODA, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2004
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.65.2231

Superior mesenteric vein thrombosis (SMVT) is rare even among emergencies causing acute abdomen. SMVT commonly lacks typical clinical manifestations and is rarely diagnosed early. We report 2 cases with different selected therapies. Case 1: A 55-year-old woman with dyspnea and pain in the left abdomen and chest was found in abdominal angiography and angio-CT to have superior mesenteric vein thrombosis (SMVT). We undertook conservative treatment by continuous urokinase infusion via a catheter in the superior mesenteric artery and systemic heparinization. Her clinical manifestations improved. Case 2: A 75-year-old man with vomiting, hematochezia, and abdominal pain was found in abdominal enhanced CT to have a central filling defect in the lumen of the superior mesenteric vein. We diagnosed this case as SMVT and conducted emergency laparotomy, identifying necrotic changes and conducting resection and anastomosis of a 170-cm segment of the small intestine. The postoperative course was uneventful.