Introduction: Acute mesenteric venous thrombosis is a rare but potentially fatal condition with superior mesenteric vein being the most common site of thrombosis development [1]. It is more common in patients with underlying disorders which cause disruptions to Virchow's Triad of hypercoagulability, stasis and endothelial injury. The disease is often associated with intestinal ischemia in its acute form, further complicating its management.
Presentation Of Case: We present a case of acute superior mesenteric venous thrombosis resulting in jejunal ischemia in a 60-year-old Caucasian male with possible ulcerative colitis. A computed tomography (CT) scan demonstrated features of intestinal infarction. However, the patient was stable after initial resuscitation with a non-peritonitic abdomen and was subsequently managed with conservative measures.
Discussion: We have illustrated a case of a patient with acute mesenteric venous thrombosis with potential bowel compromise. Despite concerning CT features, the patient was clinically stable and responded to conservative management. We hope to emphasise that although radiology plays a crucial role in modern medicine, it is important to make therapeutic decisions based on clinical findings.
Conclusion: Acute mesenteric venous thrombosis is a complex entity. It requires a multidisciplinary team approach to plan for the most appropriate treatment strategy suitable for each patient as all options are associated with significant risks. The underlying cause should be established as this will determine any long-term management necessary to prevent recurrence.
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http://dx.doi.org/10.1016/j.ijscr.2018.10.039 | DOI Listing |
Shock
January 2025
Pharmacology, University of Vermont, Burlington, VT.
Objective: Loss of function of the phospholipid scramblase (PLS) TMEM16F results in Scott Syndrome, a hereditary bleeding disorder generally attributed to intrinsic platelet dysfunction. The role of TMEM16F in endothelial cells, however, is not well understood. We sought to test the hypothesis that endothelial TMEM16F contributes to hemostasis by measuring bleeding time and venous clotting in endothelial-specific knockout (ECKO) mice.
View Article and Find Full Text PDFSurg Radiol Anat
January 2025
Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, 286-8520, Chiba, Japan.
Purpose: We present the case of a rare extrahepatic portocaval shunt that resulted in communication of the portal vein and the inferior vena cava (IVC) at the level between two right renal veins that was incidentally diagnosed with contrast-enhanced computed tomography (CECT) in an asymptomatic patient.
Methods: A woman in her sixties with abdominal pain and diarrhea of unclear origin underwent exploratory abdominal CECT.
Results: The CECT incidentally revealed an extrahepatic portocaval shunt, whereby a vessel arising from the portal vein superior to the confluence of the superior mesenteric and splenic veins drained into the posterior aspect of the IVC between two right renal veins.
Background: Pneumatosis intestinalis on CT presents a diagnostic dilemma, because it could reflect bowel ischemia or benign finding.
Purpose: To determine radiological and clinical features that can predict bowel ischemia in patients with pneumatosis intestinalis on CT.
Materials And Methods: Patients with "pneumatosis" in abdominal CT reports performed between 1/1/2002 and 12/31/2018 were retrospectively included.
Cureus
December 2024
General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
Portal vein thrombosis (PVT) typically arises in patients with underlying cirrhosis, hepatobiliary malignancies, abdominal inflammatory conditions, or hematologic disorders. However, in non-cirrhotic individuals, PVT is less common and may initially present with minimal symptoms, escalating significantly if it extends to the mesenteric veins. Here, we present the case of a 37-year-old male with combined portal and mesenteric venous thrombosis, manifesting as acute intestinal obstruction.
View Article and Find Full Text PDFLife (Basel)
January 2025
Department of Radiology, University Medical Center Regensburg, 93053 Regensburg, Germany.
Background: Portal vein thrombosis (PVT) leads to portal hypertension (PH) with its sequelae. Computed tomography spleno-mesenterico-portography (CT-SMPG) combines sequential CT spleno-portography and CT mesenterico-portography. CT-SMPG comprehensively illustrates the venous hemodynamic changes due to PH.
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