The Diagnosis and Treatment of Acute Mesenteric Venous Thrombosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGPing , WANGZhi-hong , HELiang , ZHANGDa-lin , DONGWen-wu

Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China;

Corresponding author：

ZHANGPing, Email: qwertywzh@163.com

Keywords：

Mesenteric venous thrombosis; Anticoagulation; Thrombolysis; Surgical treatment

DOI：

10.7507/1007-9424.20160211

Video：

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Objective To investigate the early diagnosis and proper treatment of acute mesenteric venous thrombosis (AMVT). Methods The clinical data of 105 cases of AMVT treated from January 2000 to December 2013 were analyzed retrospectively. Results The diagnostic accuracy of ultrasonography and abdominal contrast-enhanced CT was 67.6% (71/105), 88.0% (81/92) respectively. The accuracy rate of abdominal cavity puncture or abdominal drainage in the diagnosis of intestinal necrosis was 100% (38/38). All cases received anticoagulation and thrombolysis as soon as the definite diagnosis of AMVT were made. Twenty-five cases underwent emergency operation due to the bowel necrosis at the visiting time, Anticoagulation and thrombolysis were performed in 80 patients, of which 7 patients received surgical treatment because of ineffective anticoagulation and thrombolytic therapy. Thrombectomy was performed in 15 cases simultaneously. Surgical treatment of 32 cases, 30 cases were cured and 2 patients died of multiple organ failure or short bowel syndrome within 1 month after operation. Seventy-three cases were treated with anticoagulation therapy alone, 72 patients were cured and discharged, the effective rate was 90.0%, another 1 case died due to cerebral hemorrhage within 1 month after operation. Conclusions Early diagnosis of AMVT and bowel necrosis, timely and accurate anticoagulation and thrombolysis, and proper surgical intervention can often achieve satisfactory results.

Citation： ZHANGPing, WANGZhi-hong, HELiang, ZHANGDa-lin, DONGWen-wu. The Diagnosis and Treatment of Acute Mesenteric Venous Thrombosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(7): 805-808. doi: 10.7507/1007-9424.20160211 Copy

1.	Kumar S, Sarr MG, Kamath PS. Mesenteric venous thrombosis. N Engl J Med, 2001, 345(23): 1683-1688.
2.	Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc, 2013, 88(3): 285-94.
3.	陈建立, 张国志, 常艳, 等.急性肠系膜静脉血栓临床特点及预后影响因素分析.中国全科医学, 2012, 15(9): 1043-1044.
4.	陈玉强, 常艳, 李颐红, 等.早期诊断和迅速抗凝治疗对急性肠系膜静脉血栓的意义.河北医药, 2013, 35(9): 1376-1377.
5.	戴晓刚, 王建宏, 李树钧, 等.急性肠系膜静脉血栓形成26例诊治体会.内科急危重症杂志, 2012, 18(5): 285-287.
6.	孙力勇, 王晨龙, 朱金明, 等. 13例急性肠系膜静脉血栓临床诊治分析.实用医药杂志, 2015, 32(11): 1002-1003.
7.	Yanar F, Ağcaoğlu O, Gök AF, et al. The management of mesenteric vein thrombosis: a single institution's experience. Ulus Travma Acil Cerrahi Derg, 2013, 19(3): 223-228.
8.	黄智勇.能量多普勒超声在肠系膜静脉血栓形成中的诊断价值.中国实用医刊, 2015, 42(10): 7-8.
9.	Acosta S, Alhadad A, Ekberg O. Findings in multi-detector row CT with portal phase enhancement in patients with mesenteric venous thrombosis. Emerg Radiol, 2009, 16(6): 477-482.
10.	周倩静, 张桃, 严伟弘, 等.多层CT在诊断原发性急性肠系膜缺血中的价值.中国CT和MRI杂志, 2015, 13(6): 74-76, 116.
11.	Lee SS, Ha HK, Park SH, et al. Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis. J Comput Assist Tomogr, 2008, 32(5): 730-737.
12.	Kumar S, Kamath PS. Acute superior mesenteric venous thrombosis: one disease or two? Am J Gastroenterol, 2003, 98(6): 1299-1304.
13.	陈雄.经皮肝穿刺门静脉置管溶栓治疗急性肠系膜上静脉血栓(附7例报道).中国普外基础与临床杂志, 2010, 17(7): 731-734.
14.	Barritt D, Jordan S. Anticoagulant drugs in the treatment of pulmo-nary embolism: a controlled trial. Lancet, 1960, 1(7138): 1309-1312.
15.	Grisham A, Lohr J, Guenther JM, et al. Deciphering mesenteric venous thrombosis: imaging and treatment. Vasc Endovasc Surg, 2005, 39(6): 473-479.
16.	Condat B, Pessione F, Helene Denninger M, et al. Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology, 2000, 32(3): 466-470.
17.	杨硕菲, 吴性江, 黎介寿, 等.急性肠系膜上静脉血栓的进阶式诊治.中华胃肠外科杂志, 2014, 17(5): 516-520.
18.	王德刚.急性肠系膜静脉血栓术后抗凝溶栓的疗效评价.医学美学美容(中旬刊), 2014, (10): 666-667.
19.	李世权, 康振华, 闫国强, 等.急性肠系膜上静脉血栓形成诊断与治疗.中国老年学杂志, 2015, 35(17): 5037-5039.
20.	屈卫龙.肠系膜静脉血栓形成的诊断与手术治疗.中国保健营养(中旬刊), 2013, (5): 734.
21.	彭文生, 严立平, 朱春英, 等.肠系膜静脉血栓诊治分析.中外健康文摘, 2012, 9(2): 63-64.
22.	刘永所.肠系膜上静脉血栓形成引起的腹膜炎手术治疗体会.世界最新医学信息文摘, 2014, 14(23): 45.
23.	田延锋, 刘学刚, 吴国斌, 等.原发性肠系膜静脉血栓形成3例报道.中国普外基础与临床杂志, 2006, 13(6): 680.
24.	徐健, 陈建华, 夏茜, 等.肠系膜上静脉血栓形成致肠坏死的诊治分析(附32例报道), 中国普外基础与临床杂志, 2012, 19(4): 406-409.
25.	Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am, 1997, 77(2): 327-338.

1. Kumar S, Sarr MG, Kamath PS. Mesenteric venous thrombosis. N Engl J Med, 2001, 345(23): 1683-1688.
2. Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc, 2013, 88(3): 285-94.
3. 陈建立, 张国志, 常艳, 等.急性肠系膜静脉血栓临床特点及预后影响因素分析.中国全科医学, 2012, 15(9): 1043-1044.
4. 陈玉强, 常艳, 李颐红, 等.早期诊断和迅速抗凝治疗对急性肠系膜静脉血栓的意义.河北医药, 2013, 35(9): 1376-1377.
5. 戴晓刚, 王建宏, 李树钧, 等.急性肠系膜静脉血栓形成26例诊治体会.内科急危重症杂志, 2012, 18(5): 285-287.
6. 孙力勇, 王晨龙, 朱金明, 等. 13例急性肠系膜静脉血栓临床诊治分析.实用医药杂志, 2015, 32(11): 1002-1003.
7. Yanar F, Ağcaoğlu O, Gök AF, et al. The management of mesenteric vein thrombosis: a single institution's experience. Ulus Travma Acil Cerrahi Derg, 2013, 19(3): 223-228.
8. 黄智勇.能量多普勒超声在肠系膜静脉血栓形成中的诊断价值.中国实用医刊, 2015, 42(10): 7-8.
9. Acosta S, Alhadad A, Ekberg O. Findings in multi-detector row CT with portal phase enhancement in patients with mesenteric venous thrombosis. Emerg Radiol, 2009, 16(6): 477-482.
10. 周倩静, 张桃, 严伟弘, 等.多层CT在诊断原发性急性肠系膜缺血中的价值.中国CT和MRI杂志, 2015, 13(6): 74-76, 116.
11. Lee SS, Ha HK, Park SH, et al. Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis. J Comput Assist Tomogr, 2008, 32(5): 730-737.
12. Kumar S, Kamath PS. Acute superior mesenteric venous thrombosis: one disease or two? Am J Gastroenterol, 2003, 98(6): 1299-1304.
13. 陈雄.经皮肝穿刺门静脉置管溶栓治疗急性肠系膜上静脉血栓(附7例报道).中国普外基础与临床杂志, 2010, 17(7): 731-734.
14. Barritt D, Jordan S. Anticoagulant drugs in the treatment of pulmo-nary embolism: a controlled trial. Lancet, 1960, 1(7138): 1309-1312.
15. Grisham A, Lohr J, Guenther JM, et al. Deciphering mesenteric venous thrombosis: imaging and treatment. Vasc Endovasc Surg, 2005, 39(6): 473-479.
16. Condat B, Pessione F, Helene Denninger M, et al. Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology, 2000, 32(3): 466-470.
17. 杨硕菲, 吴性江, 黎介寿, 等.急性肠系膜上静脉血栓的进阶式诊治.中华胃肠外科杂志, 2014, 17(5): 516-520.
18. 王德刚.急性肠系膜静脉血栓术后抗凝溶栓的疗效评价.医学美学美容(中旬刊), 2014, (10): 666-667.
19. 李世权, 康振华, 闫国强, 等.急性肠系膜上静脉血栓形成诊断与治疗.中国老年学杂志, 2015, 35(17): 5037-5039.
20. 屈卫龙.肠系膜静脉血栓形成的诊断与手术治疗.中国保健营养(中旬刊), 2013, (5): 734.
21. 彭文生, 严立平, 朱春英, 等.肠系膜静脉血栓诊治分析.中外健康文摘, 2012, 9(2): 63-64.
22. 刘永所.肠系膜上静脉血栓形成引起的腹膜炎手术治疗体会.世界最新医学信息文摘, 2014, 14(23): 45.
23. 田延锋, 刘学刚, 吴国斌, 等.原发性肠系膜静脉血栓形成3例报道.中国普外基础与临床杂志, 2006, 13(6): 680.
24. 徐健, 陈建华, 夏茜, 等.肠系膜上静脉血栓形成致肠坏死的诊治分析(附32例报道), 中国普外基础与临床杂志, 2012, 19(4): 406-409.
25. Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am, 1997, 77(2): 327-338.

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The Diagnosis and Treatment of Acute Mesenteric Venous Thrombosis

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