In human anatomy, the inferior mesenteric artery, often abbreviated as ima, is the third main branch of the abdominal aorta and arises at the level of l3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. Mechanisms of thrombosis maureane hoffman, md, phd professor of pathology. The superior mesenteric vein is a blood vessel that drains blood from the small intestine jejunum and ileum. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. Computed tomography angiography was performed on all patients. Despite the rarity of its occurrence, mesenteric vascular occlusion with resultant infarction has stimulated interest among surgeons for many years. Elderly man presented with 3 days of abdominal pain and anorexia. Six of them survived and were kept on anticoagulation therapy. Thrombosis, superior mesenteric artery, mesenteric ischemia.
Mesenteric venous thrombosis mvt is an uncommon cause of mesenteric ischemia accounting for 515% of the cases. Konstantinides, md, phd, a,b stefano barco, md, mareike lankeit, md,a guy meyer, mdc abstract pulmonary embolism pe remains a. Acute mesenteric ischemia ami is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. Superior mesenteric venous thrombosis smvt is a well known cause of intestinal ischemia or infarction. It can be either acute presenting commonly with abdominal pain or chronic presenting with features of portal hypertension. Septic thrombophlebitis of the portal and superior mesenteric veins is a rare complication from an infectious. Splanchnic vein thrombosis svt is a rare condition with a poorly understood prognosis. This is due to a natural tendency towards early recurrence of pulmonary emboli which may lead to fatal. Mesenteric vein thrombosis is responsible for 20% of acute occlusive mesenteric ischemia. Nonthromboembolic causes of pulmonary embolism are rare. This is called mesenteric venous thrombosis, and it may result from this type of intestinal ischemia usually affects the small intestine. Mesenteric vein thrombosis mvt accounts for 5%15% of all mesenteric ischemic events and is classified as either primary or secondary.
Download it once and read it on your kindle device. Pathogenesis of mesenteric venous thrombosis trombosedienst. Additional mesenteric venous duplex us, including the portal vein, was performed. Multidetector ct features of mesenteric vein thrombosis. Because of a lack of specific signs or due to its sometime quiet presentation, this condition is frequently diagnosed only at an advanced stage. It is uncommon, but represents 515% of mesenteric ischemic events 1,2, with mortality rates between 15 and 40% according to different series. Mesenteric venous thrombosis is a rare cause of acute abdomen, representing only 5%15% of cases of acute mesenteric ischemia. Mvt is an uncommon cause of acute abdominal pain and accounts for 1 in emergency surgical laparotomies for acute abdomen. Primary mvt is idiopathic, whereas secondary mvt can result from a variety of underlying diseases and risk factors, including primary hypercoagulable states or prothrombotic disorders, myeloproliferative neoplasms, cancer most frequently of. Arteria mesenterica definition of arteria mesenterica by. Xpath uses path like syntax to identify and navigate nodes in an xml document. The superior mesenteric vein lies to the right of the similarly named artery, the superior mesenteric artery, which originates from the.
Thrombosis progression to the mesenteric vessels is associated with a high risk of intestinal. Mesenteric venous thrombosis mvt is a rare and insidious but potentially fatal form of mesenteric ischemia because its symptoms overlap with those of other diseases, delaying its diagnosis and treatment. Sep 04, 2018 download it once and read it on your kindle device. Jul 14, 2014 this feature is not available right now. The proportion of patients with primary, or idiopathic, mesenteric venous thrombosis continues to decline as our ability to diagnose inherited thrombotic disorders5 and to recognize. Apr 08, 2018 a randomized clinical trial of highintensity warfarin vs conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome wars. Rhee ry, gloviczki p, mendoca ct, petterson tm, serry rd, sarr mgj, et al.
Portal and mesenteric vein and inferior vena cava thrombosis. To describe the clinical features and the risk factors associated with mesente ric adenitis. The term, however, does not include isolated thrombosis of the splenic or superior mesenteric veins. Dilated bowel loops are seen with some gas in bowel wall on right side. Mesenteric ischemia mi is an uncommon medical condition with high mortality rates. Factor v proaccelerin is a coenzyme that acts on factor x of the blood coagulation cascade, enabling it to activate thrombin, which interacts with fibrinogen to convert it into. When an etiologic factor is found, patients are said to have secondary mesenteric venous thrombosis table 1. Diagnosis is often difficult, and therapy is controversial. The median time elapsed until reference was three days range 120. The regions supplied by the ima are the descending colon, the sigmoid colon, and part of the rectum.
Mesenteric vein thrombosis is a rare entity with vague symptoms. Download fulltext pdf trombosis venosa mesenterica. Angulo aortomesenterico mesenterica published on may 23, 2012 objective. This condition is termed primary when no predisposing factors can be identified. Pdf an increasing body of evidence suggests the likelihood of a link.
The deep vp, deep vein thrombosis, known as in thrombosis, or deep thrombosis, is the disease caused by the blood clotting in the inside of the veins blood vessels that take the blood back to the heart in a place or not appropriate time we must remember that clotting is a defense mechanism of the body. Caesarean section in a patient with chronic portal vein thrombosis. The most common cause is atherosclerosis, although other causes have been described, such as fibromuscular dysplasia, trauma, dissection, ruptured mesenteric aneurysm, polyarteritis nodosa, and takayasus. It revealed multiple mesenteric collections, a pancre atic cyst, and fluid in the. The proportion of patients with primary, or idiopathic, mesenteric venous thrombosis continues to decline as our ability to diagnose inherited thrombotic disorders5 and to recognize hypercoagulable states6. Higa m1, kojima m, ohnuma s, hamanaka s, yamamuro w, sugiura h, sato m. Isquemia mesenterica gastroenterologia accessmedicina. Apendicitis aguda fisiopatologia of anticoagulation in acute noncirrhotic and nonmalignant portal vein thrombosis. Portal and mesenteric vein and inferior vena cava thrombosis associated with antiphospholipid syndrome. Abdominal contrastenhanced ct scan shows no perfusion of left kidney, but small infarction is noted in right kidney. Since pvt associated with cirrhosis or due to tumour. Four common causes of mesenteric ischemia identified. Medical history of the patient, clinical suspicion, and radiological studies.
If untreated, this process will eventuate in life threatening intestinal necrosis. Chronic mesenteric venous thrombosis is an uncommon problem that can occur spontaneously or secondary to trauma, contiguous inflammation, or hypercoagulable states. Sindrome abdominal agudo por trombosis venosa mesenterica y. Blood clotting where it shouldnt or when you dont want it to. Elliot,1 in 1895, recorded the first case of mesenteric vascular occlusion for which the intestine was resected successfully. Chronic portal vein thrombosis is a rare condition, caused by various reasons, mainly thrombotic diathesis.
Sindrome abdominal agudo por trombosis venosa mesenterica. Sindrome da arteria mesenterica superior by ana marta pereira. The term misty mesentery was coined by mindelzun et al. Mesenteric venous thrombosis is classified as either primary or secondary. At its termination behind the neck of the pancreas, the superior mesenteric vein combines with the splenic vein to form the hepatic portal vein. Chylous ascytes secondary to acute pancreatitis nutricion. Pulmonary thromboembolism is a potentially lifethreatening disease, if left untreated. Enf vasc mesenteric isquemia trombo free 30day trial. Tabes mesenterica information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues. Acute mesenteric ischemia caused by venous thrombosis in a. The management of mesenteric vein thrombosis ing alone, and one patient presented with deep venous thrombosis dvt. It usually terminates when reaching the splenic vein, which goes on to form the portal vein with the superior mesenteric vein smv. Treatment of noncirrhotic, nontumoural portal vein thrombosis. Alternatively, you can download the file locally and open with any standalone pdf reader.
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