Lui G Andrea, Poniachik T Jaime, Quera P Rodrigo, Bermúdez E Cristián
Sección de Medicina Interna, Departamento de Medicina Interna, Hospital Clínico, Universidad de Chile.
Rev Med Chil. 2005 Jan;133(1):17-22. doi: 10.4067/s0034-98872005000100003. Epub 2005 Mar 10.
Mesenteric vein thrombosis (MVT) is uncommon and accounts for 5-10% of all mesenteric ischemic events. In 80% of cases, an etiologic factor is found. The clinical presentation varies and the diagnosis is made based on imaging studies. The treatment involves anticoagulation alone or in combination with surgery.
To describe the clinical characteristics of patients with MVT.
Retrospective and prospective review of all cases with MVT, treated between 1995-2001. The clinical presentation, imaging studies, treatment and outcome were evaluated.
29 cases of MVT were reviewed (14 females, age 56 +/- 15 years). Twenty two patients (76%) had recognizable risk factors. The main symptoms were abdominal pain (86%) and vomiting (55%). The diagnosis of acute mesenteric ischemia was suspected on admission only in 6 patients (21%). Thirteen patients underwent transabdominal color Doppler ultrasonography and the diagnosis was confirmed for 11 of these (85%). Twenty out of 24 patients (85%) studied with computed tomography, had positive signs of MVT. Twenty one patients (72%) received anticoagulation, 10 of whom also underwent surgery. Four patients (14%) received surgical treatment alone. Four patients were not treated. Seven patients (24%) died.
MVT is difficult to identify. It is necessary to have a high degree of suspicion in patients who have risk factors. The diagnosis is made with imaging studies. The treatment consists of early anticoagulation and surgical intervention when indicated.
肠系膜静脉血栓形成（MVT）并不常见，占所有肠系膜缺血事件的5%-10%。80%的病例可发现病因。临床表现各异，诊断基于影像学检查。治疗包括单独抗凝或抗凝联合手术。
描述MVT患者的临床特征。
对1995年至2001年期间治疗的所有MVT病例进行回顾性和前瞻性研究。评估临床表现、影像学检查、治疗及预后。
共回顾了29例MVT病例（14例女性，年龄56±15岁）。22例患者（76%）有可识别的危险因素。主要症状为腹痛（86%）和呕吐（55%）。入院时仅6例患者（21%）怀疑有急性肠系膜缺血。13例患者接受了经腹彩色多普勒超声检查，其中11例（85%）确诊。24例接受计算机断层扫描的患者中有20例（85%）有MVT阳性体征。21例患者（72%）接受了抗凝治疗，其中10例还接受了手术。4例患者（14%）仅接受了手术治疗。4例患者未接受治疗。7例患者（24%）死亡。
MVT难以识别。对有危险因素的患者必须高度怀疑。通过影像学检查进行诊断。治疗包括早期抗凝及必要时的手术干预。
