Venturini I, Cioni G, Turrini F, Gandolfo M, Modonesi G, Cosenza R, Miglioli L, Cristani A, D'Alimonte P, De Santis M, Zeneroli M L
Dipartimento di Medicina Interna, Università di Modena, Italy.
Hepatogastroenterology. 1998 Jan-Feb;45(19):44-7.
Mesenteric vein thrombosis is a rare disorder which can develop rapidly with intestinal infarction or subacutely with abdominal pain due to intestinal ischemia. Despite the availability of modern diagnostic tools, which allow an early diagnosis in most cases, the mortality from this disease has not significantly diminished over the years. The problem is that the syndrome is rare and unusual and the clinical presentation is usually vague or confusing. Particularly in cirrhotic patients, this diagnosis requires the exclusion of several other complications of liver disease, like spontaneous bacterial peritonitis, tense ascites or portal thrombosis. Here, we report the occurrence of acute mesenteric vein thrombosis in two patients with liver cirrhosis. Severe subcontinuous abdominal pain out of proportion to the physical findings and abdominal distension were the major symptoms in both patients. Magnetic resonance imaging in one case and ultrasound scan with color Doppler followed by computed tomography in the other patient confirmed the diagnosis and enabled an appropriate early therapy to be undertaken.
肠系膜静脉血栓形成是一种罕见的疾病,可迅速发展为肠梗死,也可因肠缺血而亚急性地出现腹痛。尽管有现代诊断工具,多数情况下可实现早期诊断,但多年来该疾病的死亡率并未显著降低。问题在于该综合征罕见且不常见,临床表现通常模糊或令人困惑。特别是在肝硬化患者中,做出这一诊断需要排除其他几种肝病并发症,如自发性细菌性腹膜炎、张力性腹水或门静脉血栓形成。在此,我们报告两例肝硬化患者发生急性肠系膜静脉血栓形成的病例。两名患者的主要症状均为严重的、与体格检查结果不相称的持续性腹痛及腹胀。一例患者通过磁共振成像确诊,另一例患者先进行彩色多普勒超声检查,随后行计算机断层扫描确诊,从而得以进行适当的早期治疗。