Cui Jason, Kirkby Brian
General Surgical Department, Caboolture Hospital, Caboolture, QLD 4510, Australia.
General Surgical Department, Caboolture Hospital, Caboolture, QLD 4510, Australia.
Int J Surg Case Rep. 2018;53:96-98. doi: 10.1016/j.ijscr.2018.10.039. Epub 2018 Oct 29.
Acute mesenteric venous thrombosis is a rare but potentially fatal condition with superior mesenteric vein being the most common site of thrombosis development [1]. It is more common in patients with underlying disorders which cause disruptions to Virchow's Triad of hypercoagulability, stasis and endothelial injury. The disease is often associated with intestinal ischemia in its acute form, further complicating its management.
We present a case of acute superior mesenteric venous thrombosis resulting in jejunal ischemia in a 60-year-old Caucasian male with possible ulcerative colitis. A computed tomography (CT) scan demonstrated features of intestinal infarction. However, the patient was stable after initial resuscitation with a non-peritonitic abdomen and was subsequently managed with conservative measures.
We have illustrated a case of a patient with acute mesenteric venous thrombosis with potential bowel compromise. Despite concerning CT features, the patient was clinically stable and responded to conservative management. We hope to emphasise that although radiology plays a crucial role in modern medicine, it is important to make therapeutic decisions based on clinical findings.
Acute mesenteric venous thrombosis is a complex entity. It requires a multidisciplinary team approach to plan for the most appropriate treatment strategy suitable for each patient as all options are associated with significant risks. The underlying cause should be established as this will determine any long-term management necessary to prevent recurrence.
急性肠系膜静脉血栓形成是一种罕见但可能致命的疾病,肠系膜上静脉是血栓形成最常见的部位[1]。在患有导致维勒三联征(高凝状态、血流淤滞和内皮损伤)紊乱的基础疾病的患者中更为常见。该疾病在急性期常伴有肠缺血,使其治疗更加复杂。
我们报告一例60岁患有溃疡性结肠炎可能的白种男性,因急性肠系膜上静脉血栓形成导致空肠缺血。计算机断层扫描(CT)显示有肠梗死的特征。然而,患者在最初复苏后情况稳定,腹部无腹膜炎表现,随后采用保守治疗。
我们展示了一例患有急性肠系膜静脉血栓形成且可能存在肠损伤的患者。尽管CT表现令人担忧,但患者临床情况稳定且对保守治疗有反应。我们希望强调,尽管放射学在现代医学中起着关键作用,但根据临床发现做出治疗决策很重要。
急性肠系膜静脉血栓形成是一个复杂的疾病。由于所有治疗选择都伴有重大风险,因此需要多学科团队方法来为每个患者制定最合适的治疗策略。应确定潜在病因,因为这将决定预防复发所需的任何长期治疗。