Superior mesenteric vein thrombosis

Introduction to superior mesenteric vein thrombosis Mesenteric venous thrombosis accounts for 5% to 15% of all mesenteric vascular ischemic disorders, usually involving the superior mesenteric vein, while the inferior mesenteric vein is rarely affected. The disease is clinically insidious, and the diagnosis is often delayed. In most cases, the exact diagnosis is obtained when the laparotomy is performed. Abdominal discomfort, constipation or diarrhea, after a few days or weeks, as the spread of thrombus expands, venous blood flow is blocked, affecting the intestinal tract, sudden severe abdominal pain, persistent vomiting, diarrhea and bloody water than the arteries Embolization is more common. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: edema

Cause of superior mesenteric vein thrombosis

Cause:

The disease has both primary and secondary, but secondary to more common, often accompanied by hypercoagulable state (such as polycythemia and cancer), superior mesenteric vein injury (trauma, surgery, radiotherapy, door - after vena cava shunt), abdominal infection and long-term use of contraceptives, nearly half of patients have a history of peripheral venous thromboembolic inflammation, it may be a special type of thrombophlebitis (visceral type).

Prevention of superior mesenteric vein thrombosis

Preoperative diagnosis is still difficult, angiography value is not large, mainly for the prevention and treatment of thrombosis-causing diseases, often due to acute intestinal infarction with peritonitis in the laparotomy, feasible thrombectomy, if there is intestinal necrosis, need to Intestinal resection.

Superior mesenteric venous thrombosis Complications edema

After venous thrombosis, it can continue to spread to the proximal and distal ends. When the venous return of the affected varicose veins is completely blocked, the intestines are congested and edema, and the subserosal edema first, then spread into pieces, the intestinal wall and mesentery thicken, edema, In addition, hemorrhagic infarction occurs in the intestinal tract, which is dark purple. A large amount of bloody fluid exudes from the intestinal wall and mesentery to the intestinal cavity and abdominal cavity. The acute occlusion of the vein can still cause stenosis and thrombosis of the visceral artery and accelerate the process of intestinal necrosis. Finally, it also leads to hypovolemia and toxic shock.

Symptoms of superior mesenteric vein thrombosis Common symptoms abdominal pain venous thrombosis abdominal muscle tension abdominal tenderness abdominal distension abdominal discomfort constipation watery stool diarrhea small intestine expansion inflatable

Often there is portal vein blood flow stagnation, hypercoagulable, or vascular injury, the onset is slow, manifested as abdominal discomfort, constipation or diarrhea, after a few days or weeks, as the spread of thrombus spread, venous return is blocked, affecting In the case of intestinal turf, sudden severe abdominal pain, persistent vomiting, diarrhea and bloody water are more common than arterial embolism. Physical examination shows abdominal distension, abdominal tenderness, rebound tenderness and abdominal muscle tension, and bowel sounds weaken or disappear. Abdominal puncture can draw bloody fluids, often with fever and white blood cell count, increased hematocrit, abdominal X-ray film can show the expansion of the small intestine, accompanied by a gas-liquid plane, intestinal peristalsis disappears during fluoroscopy.

Examination of superior mesenteric vein thrombosis

Physical examination showed abdominal distension, abdominal tenderness, rebound tenderness and abdominal muscle tension, bowel sounds weakened or disappeared, abdominal puncture can draw bloody fluid, often fever and white blood cell count, increased hematocrit, abdominal X-ray film can be displayed The affected small intestine is dilated and inflated, accompanied by a gas-liquid plane, and the peristalsis disappears during fluoroscopy.

Diagnosis and differentiation of superior mesenteric vein thrombosis

Can be diagnosed based on clinical performance and laboratory tests. Diseases that need to be differentiated from this disease include: gastrointestinal perforation, acute pancreatitis, intestinal torsion, intussusception, and ovarian cyst torsion.

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