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急性原发性肠系膜静脉血栓形成:一例报告及文献综述。

Acute primary mesenteric venous thrombosis: A case report and literature review.

作者信息

Lin Huiyan, Lou Yunpeng, Sha Ning, Gu Xiaofeng, Wang Zhilu, Liu Tao

机构信息

Department of Intensive Care Unit, Navy No. 971 Hospital, Qingdao 266071, Shandong Province, China.

Department of Infectious Diseases, Navy No. 971 Hospital, Qingdao 266071, Shandong Province, China.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110300. doi: 10.1016/j.ijscr.2024.110300. Epub 2024 Sep 15.

DOI:10.1016/j.ijscr.2024.110300
PMID:39288485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11420455/
Abstract

INTRODUCTION AND IMPORTANCE

Mesenteric vein thrombosis (MVT) is a pathological condition characterized by the obstruction of blood flow caused by the formation of new thrombi in the mesenteric veins, resulting in the development of intestinal ischemia due to the absence of collateral circulation. The insidious onset, clinical manifestations and lack of specificity of laboratory tests are significant factors that impede the timely diagnosis of MVT in clinical setting.

CASE PRESENTATION

This article critically examined the pathogenesis, diagnosis and treatment of a 60-year-old male patient with MVT, while also exploring the etiology, clinical manifestations, diagnostic approaches and management advancement with MVT.

CLINICAL DISCUSSION

We determined that CT angiography serves as a pivotal method for early detection of MVT. Proactive anticoagulation strategy utilizing unfractionated heparin or low molecular weight heparin can notably decrease the mortality rate of patients afflicted with MVT and enhance the clinical outcome.

CONCLUSION

Surgery is generally not endorsed as the preferential therapeutic intervention for mesenteric venous thrombosis, barring patients with concurrent intestinal necrosis or perforation.

摘要

引言与重要性

肠系膜静脉血栓形成(MVT)是一种病理状态,其特征是肠系膜静脉内形成新血栓导致血流阻塞,由于缺乏侧支循环而引发肠缺血。隐匿的起病方式、临床表现以及实验室检查缺乏特异性是临床环境中阻碍MVT及时诊断的重要因素。

病例介绍

本文对一名60岁男性MVT患者的发病机制、诊断和治疗进行了批判性研究,同时探讨了MVT的病因、临床表现、诊断方法及治疗进展。

临床讨论

我们确定CT血管造影是早期检测MVT的关键方法。使用普通肝素或低分子肝素的积极抗凝策略可显著降低MVT患者的死亡率并改善临床结局。

结论

除非患者并发肠坏死或穿孔,否则一般不推荐手术作为肠系膜静脉血栓形成的首选治疗干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/174a1d27dafd/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/0963d3a44738/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/e1b2f954bedd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/8b9dc2c3fb2f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/ee242dc621db/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/174a1d27dafd/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/0963d3a44738/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/e1b2f954bedd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/8b9dc2c3fb2f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/ee242dc621db/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca1/11420455/174a1d27dafd/gr5.jpg

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