Sasaki Ryota, Maruhashi Takaaki, Oi Marina, Takahashi Ayumi, Okazaki Kanako, Kurihara Yutaro, Asari Yasushi
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
JMA J. 2025 Apr 28;8(2):633-636. doi: 10.31662/jmaj.2024-0305. Epub 2025 Feb 7.
Superior mesenteric vein thrombosis (SMVT) is a rare condition characterized by thrombus formation in the superior mesenteric vein. SMVT is generally caused by abnormal blood coagulation, inflammation, or surgical interventions. This condition can lead to intestinal ischemia and necrosis due to blood flow stasis. We report the case of a man in his 60s who presented with abdominal pain and vomiting. Abdominal contrast-enhanced computed tomography shows a thrombus in the portal and superior mesenteric veins, and reduced contrast in the small intestine. Approximately 1.5 m of the necrotic jejunum was resected, an open management approach was undertaken, and anticoagulation with continuous intravenous heparin was initiated. On the fourth day of treatment, a thrombus was retrieved from the superior mesenteric vein within the main trunk of the portal vein using a stent clot retrieval device. The patient's bowel edema improved soon thereafter. This case of SMVT was successfully managed using a hybrid approach of bowel resection and transcatheter thrombus retrieval.
肠系膜上静脉血栓形成（SMVT）是一种罕见疾病，其特征为肠系膜上静脉内血栓形成。SMVT通常由异常凝血、炎症或手术干预引起。由于血流淤滞，这种情况可导致肠缺血和坏死。我们报告一例60多岁男性患者，其表现为腹痛和呕吐。腹部增强计算机断层扫描显示门静脉和肠系膜上静脉内有血栓，小肠造影剂减少。切除了约1.5米坏死空肠，采取开放治疗方法，并开始持续静脉注射肝素进行抗凝治疗。治疗第四天，使用支架取栓装置从门静脉主干内的肠系膜上静脉取出一枚血栓。此后不久患者的肠水肿得到改善。该例SMVT通过肠切除和经导管取栓的联合方法成功治疗。
