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Revista de la Facultad de Medicina (México)
versión On-line ISSN 2448-4865versión impresa ISSN 0026-1742
Resumen
TREJO AVILA, Mario Eduardo; ARCE LIEVANO, Elisafat; CUENDIS VELAZQUEZ, Adolfo y ROMERO LOERA, Luz Sujey. Acute abdominal pain due to portal and mesenteric venous thrombosis. Case report and topic review. Rev. Fac. Med. (Méx.) [online]. 2017, vol.60, n.1, pp.23-27. ISSN 2448-4865.
Background:
Four common causes of mesenteric ischemia identified: arterial embolism, arterial thrombosis, non-occlusive pathologies and mesenteric venous thrombosis (MVT). MVT is an uncommon cause of acute abdominal pain and accounts for 1 in 1000 emergency surgical laparotomies for acute abdomen.
Case Presentation:
A 31 year old male, previously healthy, with 72 hour history of generalized abdominal pain on examination with signs of peritonitis. He underwent a computed tomographic (CT) scan of the abdomen and pelvis, which demonstrated thrombosis of the portal, splenic and superior mesenteric veins. A laparotomy was performed, we found jejunal necrosis and a bowel resection was required. Hematologic, oncologic and autoimmune studies were performed and all of them were negative.
Discussion:
Venous thrombosis is almost always secondary to other pathologies. The principle ones are: hypercoagulability and occult neoplasia. The clinical presentation is non-specific. To make a diagnosis one can use: a Doppler ultrasound, a CT angiography, a magnetic resonance and a catheter angiography. The available treatments for acute mesenteric ischemia are: endovascular procedures, bypass surgery, anticoagulation and a laparotomy to treat visceral complications.
Conclusion:
Even if this is an uncommon pathology, physicians need to be aware of pathophysiology, diagnosis and treatment of acute mesenteric ischemia.
Palabras llave : Acute abdominal pain; mesenteric ischemia; mesenteric venous thrombosis; portal thrombosis.