This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Grisham, A. Articles by Engel, A. M. Search for Related Content PubMed PubMed Citation Articles by Grisham, A. Articles by Engel, A. M. Social Bookmarking                         What's this?

Deciphering Mesenteric Venous Thrombosis: Imaging and Treatment

Department of Surgery, Good Samaritan Hospital, Cincinnati, OH; c/o Amy Engel, Hatton Research 11-J, Good Samaritan Hospital, 375 Dixmyth Ave, Cincinnati, OH 45220

Joann Lohr, MD

J. Michael Guenther, MD

Department of Surgery, Good Samaritan Hospital, Cincinnati, OH

Amy M. Engel, MA

The E. Kenneth Hatton, MD, Institute for Research and Education, Cincinnati, OH

The principal cause of a high mortality rate in mesenteric vein thrombosis (MVT) is a delay in diagnosis. Recent data indicate that the mortality rate is decreasing owing to earlier diagnosis and anticoagulation. The authors examined the treatment profile of MVT to see how the increased use of imaging and early anticoagulation has impacted this process. They retrospectively analyzed the treatment paradigm with acute MVT at one institution over a 10-year period. Twenty-three patients were identified. Data were analyzed using chi-squares and Student's t tests. Twenty-three patients (11 men and 12 women with an average age of 51.74 ±14.8 years) were identified with acute MVT between the years of 1993 and 2003. Five patients had splenic vein thrombosis, 17 had superior mesenteric vein thrombosis, 1 had inferior mesenteric vein thrombosis, and 12 had portal vein thrombosis. Nine patients had combination mesenteric vein segment thrombosis. Thrombolytics were utilized in a total of 6 patients. Four of the 6 patients in whom lytics were utilized had combined mesenteric vein thrombosis; however, these 4 patients did not require surgical intervention. There was no significant difference in length of hospital stay between patients taking lytics versus patients treated with traditional anticoagulation with heparin (p = 0.291). A hypercoagulable state was identified in 66.7% of the patients. Four patients required surgical intervention. The overall mortality rate was 8.7% (2 of 23). The use of thrombolytics was associated with a significant mortality (p = 0.04). The use of antibiotics made no difference in mortality (p = 0.235), nor did antibiotic use influence length of hospitalization (p = 0.192). MVT is relatively rare, and often the delay in diagnosis increases the mortality rate. In the majority of cases prompt anticoagulation will preserve bowel viability and decrease mortality and morbidity rates. The majority of patients do not need surgery. There is a marked increase in mortality rate when these patients progress to surgical intervention. An increased awareness and early diagnosis has led to decreased morbidity and mortality rates.

Vascular and Endovascular Surgery, Vol. 39, No. 6, 473-479 (2005)
DOI: 10.1177/153857440503900603


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. Hotoleanu, O. Andercou, and A. Andercou Mesenteric Venous Thrombosis With Bowel Infarction and Hyperhomocysteinemia Due to Homozygous Methylenetetrahydrofolate Reductase C677T Genotype Vascular and Endovascular Surgery, October 1, 2008; 42(5): 477 - 481. [Abstract] [PDF]