Abdu R A, Zakhour B J, Dallis D J
Surgery. 1987 Apr;101(4):383-8.
The objective of this study was to identify those patients in whom mesenteric venous thrombosis (MVT) is likely to develop and to review the pathophysiology, clinical presentation, diagnostic modalities, and patient outcome. We present a review of the literature from 1911 to 1984 with respect to 372 patients with MVT, including five of our own patients. Data on 99 of these patients were obtained from autopsy reports and were not included in the study. This disease is common in the sixth and seventh decades of life, with 81% of these older patients having associated illnesses. MVT involves segments of the small bowel, but rarely of the colon, with hemorrhagic infarcts rather than gangrene. This disease does not conform to a pattern, although a prodromal period of days or weeks of abdominal pain (which is usually out of proportion to physical findings), marked leukocytosis, and dehydration are all highly suggestive of MVT. Serosanguineous fluid obtained by means of peritoneal tap is a useful diagnostic tool. A high index of suspicion, early diagnosis, and prompt surgical intervention with the addition of anticoagulants seems to improve survival and reduce recurrence.
本研究的目的是确定那些可能发生肠系膜静脉血栓形成（MVT）的患者，并回顾其病理生理学、临床表现、诊断方法及患者预后。我们对1911年至1984年间372例MVT患者的文献进行了综述，其中包括我们自己的5例患者。这些患者中有99例的数据来自尸检报告，未纳入本研究。这种疾病在60至70岁人群中较为常见，81%的老年患者伴有相关疾病。MVT累及小肠段，但很少累及结肠段，多为出血性梗死而非坏疽。尽管数天或数周的前驱性腹痛（通常与体格检查结果不符）、明显的白细胞增多和脱水都高度提示MVT，但这种疾病并不符合某一特定模式。通过腹腔穿刺获得的血清样液体是一种有用的诊断工具。高度的怀疑指数、早期诊断以及及时的手术干预并加用抗凝剂似乎可提高生存率并减少复发。
