Vascular Specialist International

The Korean Society for Vascular Surgery (대한혈관외과학회)
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Clinical Manifestations of Superior Mesenteric Venous Thrombosis in the Era of Computed Tomography

  • Cho, Joon Whoi (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Choi, Jae Jeong (Inje University College of Medicine) ;
  • Um, Eunhae (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jung, Sung Min (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Shin, Yong Chan (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jung, Sung-Won (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jae Il (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Choi, Pyong Wha (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Heo, Tae Gil (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Myung Soo (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jun, Heungman (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
  • Received : 2018.05.28
  • Accepted : 2018.09.11
  • Published : 2018.12.31
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Abstract

Purpose: Thrombosis of the portal vein, known as pylephlebitis, is a rare and fatal complication caused by intraperitoneal infections. The disease progression of superior mesenteric venous thrombosis (SMVT) is not severe. This study aimed to determine the clinical features, etiology, and prognosis of SMVT. Materials and Methods: We retrospectively reviewed the medical records of 41 patients with SMVT from March 2000 to February 2017. We obtained a list of 305 patients through the International Classification of Disease-9 code system and selected 41 patients with SMVT with computed tomography. Data from the medical records included patient demographics, comorbidities, review of system, laboratory results, clinical courses, and treatment modalities. Results: The causes of SMVT were found to be intraperitoneal inflammation in 27 patients (65.9%), malignancy in 7 patients (17.1%), and unknown in 7 patients (17.1%). Among the patients with intraperitoneal inflammation, 14 presented with appendicitis (51.9%), 7 with diverticulitis (25.9%), and 2 with ileus (7.4%). When comparing patients with and without small bowel resection, the differences in symptom duration, bowel enhancement and blood culture were significant (P=0.010, P=0.039, and P=0.028, respectively). Conclusion: SMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis. In addition, rapid symptom progression and positive blood culture can be the prognostic factors related to extensive bowel resection. Use of appropriate antibiotics and understanding of disease progression can help improve the outcomes of patients with SMVT.

Keywords

References

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  1. Management of Acute Mesenteric Venous Thrombosis: A Systematic Review of Contemporary Studies vol.110, pp.2, 2018, https://doi.org/10.1177/1457496920969084