TWO CASES OF SUPERIOR MESENTERIC VEIN THROMBOSIS

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 abdom...

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Published inNihon 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
LanguageEnglish
Published Japan Surgical Association 2004
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ISSN1345-2843
1882-5133
DOI10.3919/jjsa.65.2231

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Abstract 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.
AbstractList 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.
Author HARADA, Naoki
TAKAHASHI, Akira
TOYODA, Yasuhiro
NAKAMURA, Masahiko
ISHII, Noboru
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References 3) Warren S, Eberhard TP: Mesenteric venous thrombosis. Surg Gynecol Obstet 61: 102-105, 1935
19) 豊田和広,中塚博文,眞次康弘他:保存的加療が奏効した上腸間膜静脈血栓症の1例.日消外会誌 34: 1437-1441, 2001
21) 中原錬三,太田英正,市川敏男:上腸間膜静脈血栓症の1例.日腹部救急医会誌 19: 1003-1005, 1999
8) Witte CL, Brewer ML, Witte MH, et al: Protean manifestations of pylethrombosis. A review of thirty-four patients. Ann Surg 202: 191-202, 1985
6) 杉浦禎一,新實紀二,横井俊平他:プロテインS欠乏症による上腸間膜静脈血栓症の1例.日消外会誌 31: 2388-2391, 1998
20) 藤田利枝,小原則博,天野 実他:血栓溶解剤動注療法後に小腸狭窄を来した上腸間膜静脈血栓症の1例.日臨外会誌 61: 1053-1057, 2000
23) Jona J, Cummins GM Jr, Head HB, et al: Recurrent primary mesenteric venous thrombosis. JAMA 227: 1033-1035, 1974
5) 岩井和彦,高橋 透,水戸康文他:特発性上腸間膜静脈,門脈,脾静脈血栓症の1例.日消外会誌 32: 2370-2374, 1999
22) 渡辺 学,炭山嘉伸,武田明芳他:門脈内視鏡により血栓摘除を行った門脈血栓症の1例.日臨外会誌 59: 1354-1357, 1998
7) Thompson EN, Sherlock S: The aetiology of portal vein thrombosis with particular reference to the role of infection and exchange transfusion. QJ Med 33: 465-479, 1964
9) 松田裕子,松本正廣,水島宣章他:食道静脈瘤硬化療法後に広汎な肝内門脈血栓症を生じ肝不全で死亡した1例.日消病会誌 83: 2616-2620, 1986
16) 折井正博,秋山芳伸,森末 淳他:腸間膜静脈血栓症.手術 50: 909-915, 1996
10) 中屋考清,細川 治,津田昇志他:大腸内視鏡検査後にみられた上腸間膜静脈血栓症の1例. Gastroenterol Endosc 42: 2117-2121, 2000
17) 中尾達也,佐々木嚢,角 重雄他:術前に診断しえた特発性上腸間膜静脈血栓症の1治験例.日臨外医会誌 46: 887-890, 1991
24) 上原圭介,長谷川洋,小木曽清二他:上腸間膜静脈血栓症の1例.日臨外会誌 60: 3006-3010, 1999
11) Abdu RA, Zakhour BJ, Dallis DJ: Mesenteric venous thrombosis 1911 to 1984. Surgery 101: 2660-2664, 1987
2) Grendell JH, Ockner RK: Mesenteric venous thrombosis. Gastroenterology 82: 358-372, 1982
4) Kaleya RN: Acute mesenteric ischemia. Crit Care Clin 11: 479-512, 1995
14) 井上芳徳,岩井武尚,三浦則正他:上腸間膜静脈血栓症の1例.静脈学 3: 213-221, 1992
15) 岸淵正典,川崎勝弘,西 敏夫他: Dynamic CTにて診断可能であった上腸間膜静脈血栓症の1例.外科 62: 242-244, 2000
18) 進藤俊哉:急性腸管虚血の診断と治療.外科 64: 1138-1143, 2002
1) 川崎富夫,上林純一:腸間膜静脈血栓症.外科 57: 1575-1592, 1995
12) 桝谷佳生,石井 浩,中村広志他:肝硬変にともなう門脈血栓症の臨床的研究-特に慢性血栓症の臨床経過について-.社保医誌 41: 13-17, 2001
13) 石井貴士,島田長人,柴 忠明:上腸間膜静脈血栓症.臨外 52: 1543-1547, 1997
References_xml – reference: 4) Kaleya RN: Acute mesenteric ischemia. Crit Care Clin 11: 479-512, 1995
– reference: 9) 松田裕子,松本正廣,水島宣章他:食道静脈瘤硬化療法後に広汎な肝内門脈血栓症を生じ肝不全で死亡した1例.日消病会誌 83: 2616-2620, 1986
– reference: 7) Thompson EN, Sherlock S: The aetiology of portal vein thrombosis with particular reference to the role of infection and exchange transfusion. QJ Med 33: 465-479, 1964
– reference: 6) 杉浦禎一,新實紀二,横井俊平他:プロテインS欠乏症による上腸間膜静脈血栓症の1例.日消外会誌 31: 2388-2391, 1998
– reference: 13) 石井貴士,島田長人,柴 忠明:上腸間膜静脈血栓症.臨外 52: 1543-1547, 1997
– reference: 20) 藤田利枝,小原則博,天野 実他:血栓溶解剤動注療法後に小腸狭窄を来した上腸間膜静脈血栓症の1例.日臨外会誌 61: 1053-1057, 2000
– reference: 22) 渡辺 学,炭山嘉伸,武田明芳他:門脈内視鏡により血栓摘除を行った門脈血栓症の1例.日臨外会誌 59: 1354-1357, 1998
– reference: 2) Grendell JH, Ockner RK: Mesenteric venous thrombosis. Gastroenterology 82: 358-372, 1982
– reference: 21) 中原錬三,太田英正,市川敏男:上腸間膜静脈血栓症の1例.日腹部救急医会誌 19: 1003-1005, 1999
– reference: 5) 岩井和彦,高橋 透,水戸康文他:特発性上腸間膜静脈,門脈,脾静脈血栓症の1例.日消外会誌 32: 2370-2374, 1999
– reference: 12) 桝谷佳生,石井 浩,中村広志他:肝硬変にともなう門脈血栓症の臨床的研究-特に慢性血栓症の臨床経過について-.社保医誌 41: 13-17, 2001
– reference: 15) 岸淵正典,川崎勝弘,西 敏夫他: Dynamic CTにて診断可能であった上腸間膜静脈血栓症の1例.外科 62: 242-244, 2000
– reference: 16) 折井正博,秋山芳伸,森末 淳他:腸間膜静脈血栓症.手術 50: 909-915, 1996
– reference: 10) 中屋考清,細川 治,津田昇志他:大腸内視鏡検査後にみられた上腸間膜静脈血栓症の1例. Gastroenterol Endosc 42: 2117-2121, 2000
– reference: 11) Abdu RA, Zakhour BJ, Dallis DJ: Mesenteric venous thrombosis 1911 to 1984. Surgery 101: 2660-2664, 1987
– reference: 14) 井上芳徳,岩井武尚,三浦則正他:上腸間膜静脈血栓症の1例.静脈学 3: 213-221, 1992
– reference: 17) 中尾達也,佐々木嚢,角 重雄他:術前に診断しえた特発性上腸間膜静脈血栓症の1治験例.日臨外医会誌 46: 887-890, 1991
– reference: 8) Witte CL, Brewer ML, Witte MH, et al: Protean manifestations of pylethrombosis. A review of thirty-four patients. Ann Surg 202: 191-202, 1985
– reference: 18) 進藤俊哉:急性腸管虚血の診断と治療.外科 64: 1138-1143, 2002
– reference: 19) 豊田和広,中塚博文,眞次康弘他:保存的加療が奏効した上腸間膜静脈血栓症の1例.日消外会誌 34: 1437-1441, 2001
– reference: 3) Warren S, Eberhard TP: Mesenteric venous thrombosis. Surg Gynecol Obstet 61: 102-105, 1935
– reference: 24) 上原圭介,長谷川洋,小木曽清二他:上腸間膜静脈血栓症の1例.日臨外会誌 60: 3006-3010, 1999
– reference: 1) 川崎富夫,上林純一:腸間膜静脈血栓症.外科 57: 1575-1592, 1995
– reference: 23) Jona J, Cummins GM Jr, Head HB, et al: Recurrent primary mesenteric venous thrombosis. JAMA 227: 1033-1035, 1974
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Snippet Superior mesenteric vein thrombosis (SMVT) is rare even among emergencies causing acute abdomen. SMVT commonly lacks typical clinical manifestations and is...
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Title TWO CASES OF SUPERIOR MESENTERIC VEIN THROMBOSIS
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