Acute mesenteric venous thrombosis as the cause of ischaemia

Summary

Introduction

Mesenteric venous thrombosis (MVT) is a cause of ischaemia with a high rate of morbidity and mortality. Yet, this pathology does not present any specific clinical signs and this means that it is usually diagnosed at a late stage in its development.

Aims

The purpose of this study was to carry out a review of the literature on the subject and to analyse the cases diagnosed in our hospital in an attempt to determine their aetiopathogenesis, the method of diagnosis, treatment and prognosis of the patients involved.

Patients and methods

A descriptive retrospective study was conducted. A revision was performed of all the patients diagnosed with acute MVT between January 2000 and December 2004. A search was conducted to determine the method that allowed a diagnosis to be reached, as well as the possible associated risk factors. Both clinical and ultrasound controls were carried out.

Results

Nine patients were included. All of them were diagnosed using computerised tomography (CT). The most frequent symptom was abdominal pain (77.7%). Among the risk factors we found two tumours, one protein C deficiency and two diagnosed cases of chronic liver disease. Six of them were treated with anticoagulation therapy. Only one patient had to undergo an intestinal resection. The mortality rate at 30 days was 22% and survival at one year was 33%. One case of recurrence was recorded in a patient with a hypercoagulability status. Loss in the clinical control was 22%.

Conclusions

Mesenteric ischaemia due to venous thrombosis results in a high mortality rate. CT has proved to be the most sensitive diagnostic technique. Anticoagulation therapy is at present the preferred treatment, except in cases of intestinal necrosis.