Primary mesenteric venous thrombosis: a study from western India
Amarapurkar, D.N.; Patel, N.D.; Jatania, J.
Indian Journal of Gastroenterology Official Journal of the Indian Society of Gastroenterology 26(3): 113-117
2007
ISSN/ISBN: 0254-8860 PMID: 17704576 Document Number: 613023
The prevalence and clinical spectrum of mesenteric venous thrombosis (MVT) in India is largely unknown. We retrospectively re-viewed the case records of patients with primary mesenteric venous thrombosis seen over a 10-year period and retrieved information on clinical picture, underlying hypercoagulable states and outcome. The 28 cases (mean age 41.2 [SD 10.2] years; 19 male) included 13 with acute MVT, 10 with subacute MVT and 5 with chronic MVT. Ten patients had past thromboembolic events (multiple events in five); four patients had isolated superior mesenteric vein involvement and 14 had multiple vessel involvement. Hypercoagulable state was identified in 17 patients, with multiple etiologies in 7 patients. Pre-operative diagnosis was made in all patients. Ten patients needed surgical management; the rest were managed medically initially, but 2 required surgery on follow up. Seven patients died during a follow up of up to 10 years, with in-hospital mortality during index admission in six. Most of the patients with MVT have multiple intra-abdominal vessel involvement and underlying hypercoagulable state. The policy of early treatment with anticoagulation in all and surgical treatment as per need, achieves low mortality.