Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
Am Surg. 2023 Aug;89(8):3566-3567. doi: 10.1177/00031348231162706. Epub 2023 Mar 14.
Acute mesenteric ischemia is rare and can be difficult to diagnose due to vague symptoms often endorsed by patients. It can be fatal if not discovered in time, as it can lead to bowel ischemia, sepsis, and ultimately death. Here, we present a case of a 23-year-old female with hepatic steatosis, obesity, and 5-year history of birth control use who developed acute mesenteric ischemia secondary to superior mesenteric venous (SMV) thrombosis, requiring small bowel resection of 238 cm out of 480 cm (49.5%) after delay in diagnosis. Hypercoagulable and genetic workup during admission later revealed heterozygous factor V Leiden (FVL) mutation. The patient was ultimately discharged to inpatient rehabilitation on anticoagulation.
急性肠系膜缺血较为罕见，由于患者常伴有不明确的症状，因此诊断较为困难。如果不能及时发现，该病可能会导致肠缺血、脓毒症，最终导致死亡。在此，我们报告一例 23 岁女性病例，该患者患有肝脂肪变性、肥胖症，且有 5 年的避孕药使用史，因肠系膜上静脉（SMV）血栓形成而继发急性肠系膜缺血，在诊断延迟后，接受了 238 厘米小肠切除术，占总长度的 480 厘米（49.5%）。住院期间的高凝状态和基因检查后来发现存在杂合子因子 V 莱顿（FVL）突变。最终，该患者接受抗凝治疗后出院至住院康复治疗。
