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Mesenteric Venous Thrombosis
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Mesenteric Venous Thrombosis
, Mesenteric Vein Thrombosis
Epidemiology
Accounts for 5-15% of
Acute Mesenteric Ischemia
Gender: Women are more commonly affected
Pathophysiology
Superior
Mesenteric Artery
is affected in most cases
Causes
Prothrombotic state (70% of cases)
Family History
of
Venous Thromboembolism
(50% of cases)
Cancer
Thrombophilia
Risk Factors
Tobacco Abuse
Oral Contraceptive
use
Abdominal Trauma
(especially significant
Trauma
such as seen in
Motor Vehicle Accident
)
Symptoms
Presentation is often delayed 48 hours or more after onset
Mid-abdominal, colicky pain
May still eat despite pain
Nausea
Vomiting
Diarrhea
Signs
Fecal Occult Blood
stool (50%)
Grossly bloody stool (15%)
Labs
Lactic Acidosis
is a late finding
Imaging
Abdominal Xray
Early: Mild bowel dilation
Late: Thumb printing, pneumatosis, portal venous gas
Abdominal CT
Test Sensitivity
: 90%
Abdominal Ultrasound
with venous doppler
Management
Anticoagulation
(
Heparin
transitioned to
Warfarin
, and continued for >=6 months)
Surgery
Prognosis
Mortality: 20-50%
References
Fraboni (2012) Board Review Express, San Jose
Mastoraki (2021) World J Gastrointest Pathophysiol 7(1): 125-30 [PubMed]
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