Llovera Ingrid, Roit Zhanna, Kiriaki Shadi, Sama Andrew, Loscalzo John, Goyal Nikhil
Department of Emergency Medicine and Radiology, North Shore University Hospital, Manhasset, New York 11030, USA.
J Emerg Med. 2010 Nov;39(5):579-82. doi: 10.1016/j.jemermed.2007.05.056. Epub 2008 Jan 4.
We present an unusual case of a 31-year-old nulliparous woman who was in her normal state of health until 3 weeks before her Emergency Department visit, when she began to have generalized abdominal pain that got acutely worse over a few days. She had a soft abdomen, but complained of excruciating pain. Her computed tomography (CT) scan revealed thrombosis in the superior mesenteric, splenic, and portal veins. Her hematological work-up detected a protein S deficiency, which is associated with recurrent venous thrombosis. The finding of mesenteric venous thrombosis associated with protein S deficiency is rare. The most important factor in survival is early diagnosis and prompt treatment with anticoagulants. Properly treated, patients with mesenteric venous thrombosis should have a good long-term prognosis. Past medical or family history of thrombosis in combination with abdominal symptoms should increase the suspicion for the disease.
我们介绍了一例不同寻常的病例，患者为一名31岁未生育女性，在就诊于急诊科前3周一直健康，之后开始出现全腹疼痛，并在数天内急剧加重。她腹部柔软，但主诉疼痛难忍。她的计算机断层扫描（CT）显示肠系膜上静脉、脾静脉和门静脉血栓形成。血液学检查发现蛋白S缺乏，这与复发性静脉血栓形成有关。与蛋白S缺乏相关的肠系膜静脉血栓形成的发现很罕见。生存的最重要因素是早期诊断和及时使用抗凝剂治疗。经过适当治疗，肠系膜静脉血栓形成患者应具有良好的长期预后。有血栓形成的既往病史或家族史并伴有腹部症状时，应增加对该病的怀疑。
