Marconato Roberto, Nezi Giulia, Capovilla Giovanni, Moletta Lucia, Baldan Nicola, Canton Silvio Alen, Spirch Saverio, Salvador Renato, Merigliano Stefano
Department of Surgical, Oncological and Gastrointestinal Sciences, University of Padova, Padova, Italy.
J Surg Case Rep. 2020 Mar 24;2020(3):rjaa016. doi: 10.1093/jscr/rjaa016. eCollection 2020 Mar.
Mesenteric vein thrombosis (MVT) is a rare condition, often misdiagnosed due to its vague and misleading clinical presentation. It can cause intestinal infarction, peritonitis, and consequently necessitate bowel resection. CT scanning with intravenous contrast enhancement is the gold standard for its diagnosis. Radiologists have an important role in defining the extent of thrombosis and identifying any signs of intestinal infarction influencing the decision whether or not to operate. In patients with no clinical signs of peritonitis or radiological evidence of intestinal infarction, the treatment can be exclusively medical, based on full anticoagulation (initially with low molecular weight heparin, followed by vitamin K antagonists or direct acting oral-anticoagulants). The duration of medical treatment depends on radiological evidence of resolution of thrombosis and the identification of pro-coagulant risk factors.
肠系膜静脉血栓形成（MVT）是一种罕见疾病，常因其临床表现模糊且具有误导性而被误诊。它可导致肠梗死、腹膜炎，进而需要进行肠切除。静脉注射造影剂增强的CT扫描是其诊断的金标准。放射科医生在确定血栓形成范围以及识别任何影响手术决策的肠梗死迹象方面发挥着重要作用。对于没有腹膜炎临床体征或肠梗死影像学证据的患者，治疗可以完全采用药物治疗，基于充分抗凝（最初使用低分子量肝素，随后使用维生素K拮抗剂或直接作用的口服抗凝剂）。药物治疗的持续时间取决于血栓溶解的影像学证据以及促凝血危险因素的识别。
