A new technique for early detection of portal vein and arterial thromboses. Indwelling mesenteric venous catheterization and relevance to small bowel transplantation.

The aim of this study was to ascertain whether, in an animal model, continuous monitoring of mesenteric venous pressure (MVP) via an indwelling mesenteric venous catheter could assist in early detection of thrombosis of the portal vein (PVT) and superior mesenteric artery (SMAT). The role of portography via the catheter was also studied in confirming these complications. An animal model of PVT and SMAT was developed in pigs. At laparotomy, a 20-cm jejunal loop was isolated and a heparin-coated catheter was inserted into a mesenteric vein of the isolated jejunum and connected to a pressure transducer. Conditions of PVT were simulated by progressive occlusion of the portal vein (PV) using a silastic tourniquet and those of SMAT by superior mesenteric artery (SMA) clamping. MVPs (mm Hg) were found to significantly increase with all degrees of PV occlusion (P < 0.01, Student's t test) and to significantly decrease after SMA occlusion (P < 0.01). Portography clearly demonstrated all degrees of PV stenosis after PV occlusion and stasis of contrast medium during SMA occlusion. The authors feel that this method enables rapid diagnosis of PVT and SMAT and may be useful in the monitoring of the therapy for these complications after small bowel transplantation.