Thrombose aiguë de la veine mésentérique supérieure. Étude rétrospective de neuf cas

Abstract

Aim of the study

To determine diagnostic modalities and both immediate and long-term treatment of superior mesenteric venous thrombosis.

Patients and methods

Retrospective study from 1997 to 2004 in two institutions concerning patients with superior mesenteric vein thrombosis.

Results

Nine patients (all males, mean age = 55 years), were included. Abdominal pain (100%), vomiting (44%), and bowel activity disorders (44%) were the most common symptoms. A personal or familial thrombosis history was present in 67% of patients. A genetic predisposing factor of thrombosis was present in 78% of patients. The diagnosis was established with CT-scan in 8 cases with a mean delay of 8 days. Treatment was exclusively medical in 33% of patients and included surgery in 67%. All operated patients underwent resection for bowel infarction and only one had immediate anastomosis. All enterostomies were subsequently closed. No patient died.

Conclusion

Diagnosis of superior mesenteric vein thrombosis is frequently delayed and relies on CT-scan with intravenous contrast. Prognosis is globally favourable but depends on early application of anticoagulation therapy. In case of surgery, bowel-sparing resection is indicated and enterostomies are often needed. Genetic disorders predisposing to thrombosis are very frequent, that may indicate prolonged even definitive anticoagulation therapy.