Zhang Peng, Li Xiao-Jie, Guo Ruo-Mi, Hu Kun-Peng, Xu Shi-Lei, Liu Bo, Wang Qing-Liang
Department of General Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510530, Guangdong Province, China.
Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510530, Guangdong Province, China.
World J Clin Cases. 2021 Nov 16;9(32):9896-9902. doi: 10.12998/wjcc.v9.i32.9896.
Acute superior mesenteric venous thrombosis (MVT) is a rare condition associated with a high mortality rate. The treatment strategy for MVT is clinically challenging due to its insidious onset and rapid development, especially when accompanied by kidney transplantation.
Here we present a rare case of acute MVT developed 3 years after renal transplantation. A 49-year-old patient was admitted with acute abdominal pain and diagnosed as MVT with intestinal necrosis. An emergency exploratory laparotomy was performed to remove the infarcted segment of the bowel. Immediate systemic anticoagulation was also initiated. During the treatment, the patient experienced bleeding, anastomotic leakage, and sepsis. However, after aggressive treatment was administered, all thrombi were completely resolved, and the patient recovered with his renal graft function unimpaired.
The present case suggests that accurate diagnosis and timely surgical treatment are important to improve the survival rate of MVT patients. Bleeding with anastomotic fistula needs to be treated with caution because of grafts. Also, previously published cases of mesenteric thrombosis after renal transplantation were reviewed.
急性肠系膜上静脉血栓形成（MVT）是一种罕见疾病，死亡率很高。由于其起病隐匿且发展迅速，MVT的治疗策略在临床上具有挑战性，尤其是在伴有肾移植的情况下。
在此，我们报告一例肾移植3年后发生急性MVT的罕见病例。一名49岁患者因急性腹痛入院，被诊断为MVT伴肠坏死。进行了急诊剖腹探查术以切除梗死肠段。同时立即开始全身抗凝治疗。在治疗过程中，患者出现出血、吻合口漏和脓毒症。然而，经过积极治疗，所有血栓完全溶解，患者康复，肾移植功能未受损害。
本病例表明，准确诊断和及时手术治疗对于提高MVT患者的生存率很重要。由于存在移植肾，吻合口瘘合并出血需要谨慎处理。此外，还对先前发表的肾移植后肠系膜血栓形成病例进行了回顾。
