Acute superior mesenteric vein thrombosis associated with abdominal trauma

Abstract

Rationale:Acute mesenteric vein thrombosis (MVT) is defined as new-onset thrombosis of the mesenteric vein without evidence of collateralization, finally resulting in extensive intestinal infarction. MVT may be idiopathic or be caused by conditions responsible for thrombophilia and acquired risk factors. To date, there have been few reports of MVT after trauma. Herein we describe our experiences treating three patients with MVT.Patient concerns:Case 1 was a 44-year-old man with transverse colon mesenteric hematoma after blunt abdominal trauma. Case 2 was a 55-year-old man with jejunal transection after a traffic accident. Case 3 was a 26-year-old man presented with multiple abdominal stab bowel injury.Diagnoses:A 1-week follow-up abdominal computed tomography scan showed superior mesenteric vein thrombosis in all of three patients.Interventions:All patients were treated with anticoagulant for 3 or 6 months.Outcomes:MVTs were completely resolved without any complications.Lessons:If early diagnosis and treatment could be available, anticoagulation alone might be adequate for the treatment of SMVT associated with trauma. Early anticoagulation in patients with acute SMVT may avoid the grave prognosis observed in patients with arterial thrombosis.

Post-traumatic superior mesenteric venous thrombosis with subsequent extension to the portal vein

“…The superior mesenteric vein is most commonly affected [2] , [3] , [7] , [8] . It most often involves the ileum (64%-83%) and jejunum (50%-81%), followed by the colon (14%), and duodenum (4%-8%) [5] .…”

“…The most frequently acquired prothrombotic state results from intra-abdominal neoplasia, inflammatory bowel disease, pregnancy, major trauma, postoperative conditions (especially splenectomy), cirrhosis, and portal hypertension. Oral contraceptive use is responsible for 9%-18% of mesenteric vein thrombosis (MVTs) in young women [3] , [5] , [10] , [11] , [12] , [13] . When the underlying etiology cannot be identified, the thrombosis is defined as primary or idiopathic [2] .…”

“…Leukocytosis and hemoconcentration are commonly observed. Serum lactate levels may increase, but do not always correlate with the severity of the thrombosis [2] , [5] .…”

“…Some of the common risk factors for the development of acute mesenteric vein thrombosis include a prothrombotic state, surgery, inflammatory bowel disease, malignancy pancreatitis, and infection [4] . Cases of acute mesenteric vein thrombosis associated with polytrauma (serious vehicle accidents) or multiple stab wounds to the abdomen have been reported in the literature [5] .…”

Trombosis porto-mesentérica aislada secundaria a trauma abdominal cerrado

“…El riesgo de sufrir de TVPM para la población sana es del 1 %, mientras que en presencia de factores de riesgo es del orden de 4,4 al 15 % 6,10 . Esta patología representa el 0,01 % de los ingresos hospitalarios por urgencias quirúrgicas 3,4,11 y el 0,002 % al 0,06 % de los ingresos totales 12 . La trombosis venosa mesentérica aguda ocurre con mayor frecuencia en el íleon (64-83 %) y yeyuno (50-81 %), seguido del colon (14 %) y duodeno (4-8 %).…”