mesenteric venous thrombosis


Also found in: Acronyms.

mesenteric venous thrombosis

A form of mesenteric ischaemia caused by venous thrombosis, which has a high (±30%) mortality rate due to the delay in diagnosis.
 
Clinical findings
Vague abdominal discomfort that evolves over 7–10 days; abdominal distension and guaiac-positive stool.

Aetiology
Idiopathic (up to 50%), hypercoagulability (e.g., polycythemia vera), protein C and S deficiencies, intra-abdominal sepsis, systemic infection and a variety other conditions, including: portal hypertension, perforated viscus, blunt abdominal trauma, malignancy, prior abdominal surgery (open or laparoscopic), pancreatitis, smoking, oral contraceptive use, splenectomy, colectomy, Roux-en-Y gastric bypass.

Imaging
• CT (technique of choice)—Enlarged mesenteric or portal vein with sharp venous wall definition and low density within the vein.
• Arteriogram—Vasospasm, contrast in bowel lumen, non-visualised venous system, reflux of contrast into aorta, absent flow to necrotic bowel areas.

Lab
Cytology and lab data are completely ineffective, nonspecific or too late to help.

Management
Immediate bowel resection and maintain a low threshold for second-look laparotomy; long-term anticoagulation.

mesenteric venous thrombosis

Vascular disease A blood clot occluding the mesenteric vein, a major vein located in the tissue that connects the intestine to the posterior abdominal wall
References in periodicals archive ?
Patients with mesenteric venous thrombosis who don't respond to anticoagulation may be treated endovascularly with transhepatic or transjugular approaches to remove thrombus and re-establish blood flow.
Shunt occlusion and acute portal, splenic, and mesenteric venous thrombosis complicating placement of a transjugular intrahepatic portosystemic shunt.
The causes of mesenteric venous thrombosis (MVT) can be categorized into trauma, mechanical, infection, and hematologic disorders (Table).
Mesenteric venous thrombosis is more common in the sixth and seventh decades of life.
Mesenteric venous thrombosis in two women taking oral contraceptives.
Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists: a multi-centre, retrospective cohort study.
INTRODUCTION: Mesenteric venous thrombosis is a rare and life threatening condition which accounts for less than 1 in 1000 laparotomies for acute abdomen.
DISCUSSION: Mesenteric venous thrombosis (also known as visceral venous thrombosis) is a rare but lethal form of mesenteric ischemia.
et al: Mesenteric venous thrombosis and factors associated with mortality: a statistical analysis with five-year follow-up.