Multidisciplinary Stepwise Management Strategy for Acute Superior Mesenteric Venous Thrombosis: An Intestinal Stroke Center Experience

Yang, Shuofei; Fan, Xinxin; Ding, Weiwei; Bao-chen, Liu; Meng, Juan; Xu, Dongmei; He, Changsheng; Yu, Wenkui; Wu, Xiaohu; Li, Jieshou

doi:10.1016/j.thromres.2014.10.018

Cited by 46 publications

(48 citation statements)

References 41 publications

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“…This case seires research was conducted in an integrated ISC in China, which was set up in 2010 [10,11].…”

Section: Patient Characteristicsmentioning

confidence: 99%

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Sun

Wang

Chu

et al. 2020

Preprint

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Background Acute mesenteric venous thrombosis (AMVT) can not only cause acute bowel infarction but result in post-ischemic intestinal stenosis (PIIS), which is rarely reported. Methods Consecutive patients diagnosed with PIIS secondary to AMVT (during the post-thrombotic course, confirmed segmental bowel stenosis) from January 2010 to June 2018 were enrolled. We evaluated the clinical profile, response to therapy, and outcomes of this complication managed at the intestinal stroke center in China. Clinical data are retrospectively analyzed and Wilcoxon signed-rank test was used to evaluate the efficiency of conservative treatment. Results 42 patients with PIIS secondary to AMVT were evaluated. 20 (5-150) days after discharge for AMVT, symptoms of PIIS appeared, and the interval between symptom onset and consultation was 29.5 (2-180) days. In addition, abdominal pain (90.5%), abdominal distension (76.2%), weight loss (71.4%), and nausea or vomiting (54.8%) were the common presentations. Hypoproteinemia was observed in 61.9% of patients, while leukocytosis, anemia and electrolyte disorders were present in 11.9%, 45.2% and 35.7% of patients, respectively. CT excluded thrombosis recurrence and revealed extensive collateral circulation or portal cavernous transformation in 83.3% of patients. Enterography was required only in 81.0% of patients, with positive findings in all patients, including complete obstruction (23.5%), intestinal stricture (64.7%), and extensive mucosal erosion (11.8%). Prompt conservative treatment achieved significantly increases of albumin and pre-albumin levels and correction of electrolyte disorders (all p < 0.05). However, only 4 (9.5%) patients improved after conservative therapy and laparotomy was required in other patients. A median length of 20 (2-100) cm of involved bowel was resected, mainly involving the jejunum (76.3%). Only 1 patient died due to uncontrolled transverse colon bleeding, and other patients’ postoperative courses were uneventful. Conclusion During the post-thrombotic course, clinicians should be aware of the possibility of PIIS in patients with symptoms of ileus and hypoproteinemia. Patients may respond to conservative therapy; however, the majority of patients warrant surgical resection.

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“…This case seires research was conducted in an integrated ISC in China, which was set up in 2010 [10,11].…”

Section: Patient Characteristicsmentioning

confidence: 99%

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Sun

Wang

Chu

et al. 2020

Preprint

Self Cite

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“…Согласно данным недавних исследований, добавление к антикоагулянтной терапии тромболизиса способствовало реканализации вен в 88-100% наблюдений. Кроме того, в этой группе больных было отмечено значительное снижение количества выполненных резекций кишечника [27][28][29]. Несмотря на хорошие результаты исследований, сообщается, что они получены в малом числе наблюдений.…”

Section: причины венозного мезентериального тромбозаunclassified

Mesenteric venous thrombosis

Болдин

Ponomar

2017

Khir. Z. im. N.I. Pirogova

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“…In fact, MVT has a variety of risk factors for mortality extensively reported in the literature [9][10][11][12]: malignancy, renal insufficiency, age N60 years, cirrhosis, prolonged symptom duration N48 hours, and bowel resection to be independent predictors of mortality of MVT. Moreover, colon ischemia, short-bowel syndrome, secondlook laparotomy, failure of anticoagulation are significantly associated with mortality.…”

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confidence: 99%

“…In this context, the article by Yang S et al [9], in this issue of Thrombosis Research, is particularly appreciated, as it shows the importance to have a specialized and integrated Intestinal Stroke Center (ISC) in order to achieve an ideal coordination among gastroenterology physician, gastrointestinal and vascular surgeon and intervention radiologist for this important therapeutic challenge for a disease with a complex pathogenesis with no optimal treatment algorithms or guidelines to date and with a very high mortality and morbidity.…”

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confidence: 99%

“…The study by Yang S et al [9] is based on the principle of Multidisciplinary Stepwise Management Strategy according to which an integrated ISC and detailed recanalization algorithm for each pathophysiology progress, based on current consensus in the literature and pragmatic experience in intestinal failure management, were established to ensure the efficacy and the practicability of the treatments. The therapeutic principle of MVT was to achieve early recognition and mesenteric recanalization, thereby to salvage more reversible bowel.…”

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confidence: 99%

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Mesenteric Venous Thrombosis and the need for a specialized Intestinal Stroke Center

Serra¹,

Franciscis²

2015

Thrombosis Research

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Multidisciplinary Stepwise Management Strategy for Acute Superior Mesenteric Venous Thrombosis: An Intestinal Stroke Center Experience

Cited by 46 publications

References 41 publications

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Mesenteric venous thrombosis

Mesenteric Venous Thrombosis and the need for a specialized Intestinal Stroke Center

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