Angiography diagnosed acute mesenteric venous thrombosis in five 72% of seven patients. Abdu ra, zakhour bj, dallis dj 1987 mesenteric venous 9396 thrombosis 1911 to 1984. In the past, most cases were thought to be secondary to other intraabdominal pathologic conditions such as malignancy, intraabdominal sepsis, or pancreatitis or were. Mesenteric venous thrombosis ian g harnik, lawrence j. It was first described by elliot 9 in 1895 as thrombosis of the portomesenteric venous system, which disallowed venous drainage from the gut leading to bowel infarction. Mesenteric vein thrombosis an overview sciencedirect topics. Primary mvt is idiopathic, whereas secondary mvt can result from a variety of underlying diseases and risk factors, including primary hypercoagulable states or prothrombotic disorders, myeloproliferative neoplasms, cancer most frequently of the pancreas or. Review article current concepts current concepts m esenteric v enous t hrombosis. Determinants of mortality and treatment outcome following surgical interven tions for acute. Feb 15, 2014 abdu ra, zakhour bj, dallis dj 1987 mesenteric venous 9396 thrombosis 1911 to 1984. Mesenteric and portal venous thrombosis treated by transjugular mechanical thrombolysis daniel y. Thieme ejournals thrombosis and haemostasis abstract. This condition is rare, but it can lead to lifethreatening. Mesenteric venous thrombosis is a dangerous, somewhat uncommon abdominal catastrophe that has received little attention.
Case report collana di aggiornamenti della scuola medica ospedaliera b. Montgomery, md, phd assistant in surgery the johns hopkins university school of medicine baltimore, maryland anthony c. Acute mesenteric ischemia ami is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall. Treatment of acute superior mesenteric vein thrombosis with percutaneous techniques. Courtesy of brandon dessecker, md, melanie nukula, md, and robert marx, do. We retrospectively analyzed data for patients who were admitted with mvt between. Abdu ra, zakhour bj, dallis dj 1987 mesenteric venous thrombosis 1911 to 1984.
Use of transjugular intrahepatic portosystemic shunts during lytic therapy of extensive portal splenic and mesenteric venous thrombosis. The survival rate has not improved substantially during the past 70. Ct scan demonstrating cavernous change of superior mesenteric. Improved diagnosis and treatment of mesenteric obstructive arterial disease and its complications have occurred. Apr, 2014 mesenteric venous thrombosis mvt is an uncommon cause of mesenteric ischemia accounting for 515% of the cases. Abdu ra, zakhour bj, dallis dj mesenteric venous thrombosis 1911 to 1984. Mar 26, 2020 mesenteric venous air is common finding in advanced acute mesenteric ischemia. Mesenteric venous thrombosis accounts for 5 to 15 percent of all mesenteric ischemic events 3 and usually involves the superior mesenteric vein. An intrinsic anticoagulant deficiency state because of antithrombin iii, protein c, or protein s deficiency may be associated with mesenteric venous thrombosis. Bioline international official site site updated regularly. Mesenteric vein thrombosis mvt accounts for 5%15% of all mesenteric ischemic events and is classified as either primary or secondary. Venbrux, md associate professor of radiology associate director, cardiovascular diagnostic laboratory the johns hopkins university school of medicine baltimore, maryland gregory b. Oct 26, 2014 treatment of mesenteric venous thrombosis.
This study was designed to evaluate progress in diagnosis, management, and clinical outcome of mesenteric venous thrombosis mvt. Treatment of acute superior mesenteric vein thrombosis. Mesenteric venous thrombosis mvt is the least common cause of mesenteric ischemia, representing up to 10% of all patients with mesenteric ischemia and 18% of those with ami. Pdf first differentiated from arterial causes of acute mesenteric ischemia 75 years ago. Mesenteric venous thrombosis occurs when a blood clot forms in one or more of the major veins that drain blood from your intestines. Current problems in sur volume 34 number 12 ry december 1997 11 robert a. Johnson cc, baggenstoss ah 1949 mesenteric vascular oc 7.
Mesenteric vein thrombosis almost always involves the distal small intestine superior mesenteric venous drainage and rarely involves the colon inferior mesenteric venous drainage. Mesenteric venous thrombosis journal of vascular surgery. Mesenteric venous thrombosis, presenting as ischemic bowel disease, has the same poor prognosis if not aggressively diagnosed and treated. By 19, trotter 2 accumulated reports of 360 cases of mesenteric ischemia, 41% of which were mesenteric venous thrombosis. Fiftythree patients had acute and 19 had chronic mesenteric venous thrombosis. Mesenteric venous thrombosis mvt is an uncommon cause of mesenteric ischemia accounting for 515% of the cases. Mar 26, 2020 acute mesenteric ischemia ami is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall.
Kaplan jl, weintraub sl, hunt jp, gonzalez a, lopera j, brazzini a. Sudden death due to mesenteric vein thrombosis in a. First differentiated from arterial causes of acute mesenteric ischemia 75 years ago, acute mesenteric venous thrombosis mvt is an uncommon disorder with nonspecific signs and symptoms, the diagnosis of which requires a high index of suspicion. Acute mesenteric ischemia ami is a potentially fatal vascular emergency with overall mortality of 60% to 80%, 15 and its reported incidence is increasing.
The newer imaging techniques allow earlier diagnosis. All patients seen between 1983 and 1999 were enrolled into this retrospective study if recent portal or. Venbrux, md associate professor of radiology associate director, cardiovascular diagnostic laboratory the johns hopkins university school of medicine baltimore, maryland. Treatment of acute mesenteric venous thrombosis with transjugular intramesenteric urokinase infusion. Treatment of mesenteric venous thrombosis springerlink. We retrospectively analyzed data for patients who were admitted with mvt between june 2005 and may 2012 in qatar. Mesenteric venous thrombosis is an insidious disease with a high mortality rate typically attributed to the long delay in diagnosis. It can be either acute presenting commonly with abdominal pain or chronic presenting with features of portal hypertension. The survival rate has not improved substantially during the past 70 years, and the major reason is the continued. Although relatively rare, it is a potentially lifethreatening condition. Mesenteric vascular insufficiency, current problems in. Multidetector ct features of mesenteric vein thrombosis.
Only 372 patients with mvt were reported from 1911 to 1984,37 and mvt accounted for only 6. Trombosis venosa mesenterica en mujeres transexuales. Mesenteric venous thrombosis ian g harnik, lawrence j brandt. Most cases of acute mesenteric venous thrombosis evolve toward the chronic form with vein stenosis or occlusion and development of collateral veins. The anatomic site of involvement in acute mesenteric venous thrombosis is most often ileum 64 to 83 percent or jejunum 50 to 81 percent, followed by colon. Treatment of acute superior mesenteric vein thrombosis with. The operative relief of gangrene of intestine due to occlusion of the mesenteric vessels. For chronic mvt, treatment involves either anticoagulation if there is an underlying systemic coagulopathy, management of intraabdominal perivenous pathology if that is the cause of the mvt e.
Mesenteric venous thrombosis mvt is an uncommon event. The location, extent, and rapidity of thrombus formation determine whether intestinal infarction. She was diagnosed to have superior mesenteric vein thrombosis. Case records of the massachusetts general hospital. It was first described by elliot 9 in 1895 as thrombosis of the portomesenteric venous system, which. Mesenteric venous thrombosis usually involves the superior mesenteric vein, with the danger of bowel infarction. Apr 25, 2020 mesenteric venous thrombosis 1911 to 1984. Broadly, ami may be classified as either arterial or venous. Patients with this condition benefit from rapid diagnosis and expedient surgical therapy. Metastatic oesophageal carcinoma presenting as small. Twenty patients were treated in the first period of the study 1972 to 1983 and 52 in the last decade 1984 to 1993.
Full text of south dakota journal of medicine see other formats. Abdominal pain represents the most common manifestation of mvt and is present in approximately 75% to 90% of patients. Biplanar angiography of the mesenteric arteries remains the best method of diagnosing mesenteric vascular diseases, though duplex sonography of the mesenteric arteries appears to be a valuable screening tool. Mesenteric fat infiltration at diagnosis was more frequent in the chronic mesenteric venous thrombosis signs group than in the complete recovery group p 0. The risk of acute mesenteric venous thrombosis increases in patients with hypercoagulable states e.
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