Objective To discuss the early diagnosis and surgery of intestinal necrosis caused by superior mesenteric venous thrombosis (SMVT).
Methords The clinical data of 32 patients with intestinal necrosis caused by SMVT were reviewed retrospectively and analyzed, which included 6 cases of primary SMVT, 26 cases of secondary SMVT, 9 cases with pylethrombosis, 24 patients had been dignosed definitely as SMVT by imageology examination before surgery. All the patients accepted surgery therapy, within which 9 patients accepted Fogarty catheter, and anticoagulation and thrombolytic therapy were administrated postoperatively.
Results All patients had recovered except for one with short bowel syndromle and one died.
Conclusions SMVT is a rarely ischemic intestinal disease, which has complicated pathogenesis and difficulty in early diagnosis. Intestinal necrosis often occurs as a result of delayed treatment and the effective way is to cut off necrotic intestines in time. Intra-and postoperative anticoagulation and thrombolytic therapy could reduce recurrency effectively.
Citation:
XU Jian,CHEN Jianhua,XIA Qian,MA Wenfeng,ZHANG Jian,DUAN Zhiquan,XIN Shijie.. Analysis for Diagnosis and Therapy of Intestinal Necrosis Caused by Superior Mesenteric Venous Thrombosis(Reports of 32 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 406-409. doi:
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- 1. Kumar S, Sarr MG, Kamath PS. Mesenteric venous thrombosis [J]. N Engl J Med, 2001, 345(23): 1683-1688.
- 2. Grisham A, Lohr J, Guenther JM, et al. Deciphering mesentericvenous thrombosis: imaging and treatment [J]. Vasc Endovascular Surg, 2005, 39(6): 473-479.
- 3. 潘凯, 夏利刚, 陈小春, 等. 术后早期肠系膜静脉血栓形成的诊断与治疗 [J]. 中华胃肠外科杂志, 2005, 8(1): 50-52.
- 4. 赵登秋, 张喜, 姜宝飞, 等. 老年人肠系膜上静脉血栓形成16例诊治分析 [J]. 中华胃肠外科杂志, 2006, 9(3): 269-270.
- 5. 朱兴国, 李德春. 门静脉高压症肠系膜静脉血栓形成致绞窄性肠梗阻的诊治体会 [J]. 中华普通外科杂志, 2006, 21(10):689-699.
- 6. Abdu RA, Zakhour BJ, Dallis DJ. Mesenteric venous thrombosis [J]. Surgery, 1987, 101(4): 383-388.
- 7. 张强. 急性肠系膜静脉血栓的诊断与治疗 [J]. 中国实用外科杂志, 2003, 23(4):200.
- 8. 张秋学, 刘汝海, 李凤山, 等. 断流术后门静脉系统血栓形成八例 [J]. 中华普通外科杂志, 2004, 19(11): 692.
- 9. Hassan HA, Raufman JP. Mesenteric venous thrombosis [J].South Med J, 1999, 92(6): 558-562.
- 10. 张弘彬. 急性肠系膜静脉血栓的治疗( 附6 例报告) [J]. 中国医师杂志, 2003, 5(11): 1526-1527.
- 11. 段志泉, 孙成林. 肠系膜静脉血栓形成的诊断与治疗 [J]. 中华医学杂志, 2004, 84(18):1572-1574.
- 12. 王长友, 刘彩云, 陈海龙. 肠系膜静脉血栓形成的影像学评价 [J]. 医学综述, 2005, 11(1): 91-93.
- 13. 薛秀荣, 孙云川, 聂书汇, 等. 超声在诊断肠系膜静脉血栓形成中的价值 [J]. 中国介入影像与治疗学, 2007, 4(6): 470-472.
- 14. 李爱华, 孙云川. 急性肠系膜静脉血栓形成的超声诊断 [J].中国医师杂志, 9(11): 1533-1534.
- 15. Bradbury MS, Kavanagh PV, Bechtold RE, et al. Mesenteric venous thrombosis: diagnosis and noninvasive imaging [J].Radiographics, 2002, 22(3): 527-541.
- 16. 孙如泉, 张桂成, 宋兆伟, 等. 急性肠系膜上静脉血栓形成的诊断 [J]. 中华放射学杂志, 2004, 38(12): 1321-1323.
- 17. 莫友发, 张礼娟, 李想良, 等. 门静脉和肠系膜上静脉血栓形成的CT, MRI 诊断 [J]. 中华肝胆外科杂志, 2007, 13(1):22-24.
- 18. Wiesner W, Khurana B, Ji H, et al. CT of acute bowel ischemia [J]. Radiology, 2003, 226(3): 635-650.
- 19. Choudhary AM, Grayer D, Nelson A, et al. Mesenteric venous thrombosis:a diagnosis not to be missed [J]. J Clin Gastroenterol,2000, 31(2): 179-182.
- 20. Lock G. Acute mesenteric ischemia classification, evaluation and therapy [J]. Acta Gastroenterol Belg, 2002, 65(4): 220-225.
- 21. 楼国春, 杜勤, 董向毅, 等. 缺血性肠病17 例临床表现及误诊分析 [J]. 中华内科杂志, 2006, 45(1): 49-50.
- 22. Divino CM, Park IS, Angel LP, et al. A retrospective study of diagnosis and management of mesenteric vein thrombosis [J].Am J Surg, 2001, 181(1): 20-23.
- 23. Choudhary AM, Grayer D, Nelson A, et al. Mesenteric venous thrombosis: a diagnosis not to be missed [J]. J Clin Gastroenterol,2000, 31(2): 179-182.
- 24. Morasch MD, Ebaugh JL, Chiou AC, et al. Mesenteric venous thrombosis: a changing clinical entity [J]. J Vasc Surg, 2001,34(4): 680-684.
- 25. 张健, 段志泉, 罗英伟, 等. 急性肠系膜上静脉血栓形成的诊治分析 [J]. 中华普通外科杂志, 2005, 20(1): 21-23.
- 26. 丛林, 于建春, 刘昌伟, 等. 急性肠系膜静脉血栓形成27 例诊治体会 [J]. 中华外科杂志, 2008, 46(6): 423-426.