II. Epidemiology

  1. Accounts for 5-15% of Acute Mesenteric Ischemia
  2. Gender: Women are more commonly affected

III. Pathophysiology

  1. Superior Mesenteric Artery is affected in most cases

IV. Causes

  1. Prothrombotic state (70% of cases)
    1. Family History of Venous Thromboembolism (50% of cases)
    2. Cancer
    3. Thrombophilia

V. Risk Factors

  1. Tobacco Abuse
  2. Oral Contraceptive use
  3. Abdominal Trauma (especially significant Trauma such as seen in Motor Vehicle Accident)

VI. Symptoms

  1. Presentation is often delayed 48 hours or more after onset
  2. Mid-abdominal, colicky pain
    1. May still eat despite pain
  3. Nausea
  4. Vomiting
  5. Diarrhea

VII. Signs

  1. Fecal Occult Blood stool (50%)
  2. Grossly bloody stool (15%)

VIII. Labs

  1. Lactic Acidosis is a late finding

IX. Imaging

  1. Abdominal Xray
    1. Early: Mild bowel dilation
    2. Late: Thumb printing, pneumatosis, portal venous gas
  2. Abdominal CT
    1. Test Sensitivity: 90%
  3. Abdominal Ultrasound with venous doppler

X. Management

  1. Anticoagulation (Heparin transitioned to Warfarin, and continued for >=6 months)
  2. Surgery

XI. Prognosis

  1. Mortality: 20-50%

XII. References

  1. Fraboni (2012) Board Review Express, San Jose
  2. Mastoraki (2021) World J Gastrointest Pathophysiol 7(1): 125-30 [PubMed]

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Related Studies

Ontology: Mesenteric Venous Thrombosis (C0267412)

Concepts Disease or Syndrome (T047)
MSH D065666
SnomedCT 77244002, 197003001, 196998009, 95446005
English THROMBOSIS MESENTERIC VESSEL, Mesenteric thrombus NOS, Mesenteric thrombosis, MESENTERIC VEIN THROMBOSIS, thrombosis of mesenteric vein, thrombosis of mesenteric vein (diagnosis), Mesenteric vein thrombosis, Thrombosis mesenteric vein, Vein thrombosis mesenteric, mesenteric thrombosis, thrombosis mesenteric, mesenteric venous thrombosis, Thrombosis:mesenteric, mesenteric vein thrombosis, mesenteric thrombus, Mesenteric thrombus NOS (disorder), Mesenteric venous thrombosis (disorder), Mesenteric venous thrombosis, Thrombosis, Mesenteric Venous, Thromboses, Mesenteric Venous, Mesenteric Venous Thromboses, Mesenteric Venous Thrombosis, Venous Thromboses, Mesenteric, Venous Thrombosis, Mesenteric, Thrombosis of mesenteric vein, Thrombosis of mesenteric vein (disorder), mesenteric; thrombosis, thrombosis; mesenteric, Mesenteric venous thrombosis -RETIRED-, Thrombosis mesenteric vessel
Dutch trombose mesenterisch vat, trombose mesenterische ader, mesenterische trombose, mesenteriaal; trombose, trombose; mesenteriaal, mesenterische ader trombose
French Thrombose d'un vaisseau mésentérique, Thrombose mésentérique, THROMBOSE DE LA VEINE MESENTERIQU, THROMBOSE VAISSEAU MESENTERIQUE, Thrombose de la veine mésentérique
German Thrombose eines Mesenterialgefaesses, Thrombose der Vena mesenterica, Vena mesenterica Thrombose, Mesenterialthrombose, THROMBOSE MESENTERIALGEFAESSE, mesenteriale Venenthrombose
Italian Trombosi della vena mesenterica, Trombosi di vaso mesenterico, Trombosi mesenterica
Portuguese Trombose de vaso mesentérico, Trombose venosa mesentérica, Trombose mesentérica, TROMBOSE DA VEIA MESENTERICA, Trombose da veia mesentérica
Spanish Trombosis de vaso mesentérico, Trombosis venosa mesentérica, Trombosis mesentérica, TROMBOSIS MESENTERICA, trombo mesentérico, SAI, trombo mesentérico, SAI (trastorno), trombosis venosa mesentérica - RETIRADO - (concepto no activo), trombosis venosa mesentérica - RETIRADO -, trombosis de la vena mesentérica (trastorno), trombosis de la vena mesentérica, Trombosis de la vena mesentérica
Japanese 腸間膜血栓症, 腸間膜静脈血栓症, 腸間膜血栓, チョウカンマクケッセンショウ, チョウカンマクケッセン, チョウカンマクジョウミャクケッセンショウ
Czech Trombóza mezenterické cévy, Mezenterická trombóza, Trombóza mezenterické žíly, Trombóza mezenterické vény
Hungarian Mesenterikus ér thrombosis, Mesenterikus vena thrombosisa, Vena mesenterica thrombosisa, Mesenterikus thrombosis, Vena mesenterica thrombosis