Superior mesenteric venous thrombosis: a retrospective study of thirteen cases.

OBJECTIVE

To analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT) at an university hospital in Madrid.

METHODS

Retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software.

METHODS

All thirteen subjects diagnosed with SMVT in that period were included.

RESULTS

Associated risk factors included tumoral conditions (5 patients), acute abdominal pathology (2), polyglobulia (1), prothrombin gene mutation (1), and anticardiolipin antibodies (1). No predisposing factor was found in 3 patients. Clinical presentation for all patients was abdominal pain, with nausea and vomiting being the second symptom in frequency (7). The diagnosis was reached by abdominal CT (9), arteriography (2), ultrasounds (1), and histology after intestinal resection (1). Treatment with only anticoagulation was initiated in 4 patients, whereas anticoagulation and surgery were performed in 5 cases. In 4 subjects no specific treatment was prescribed and only palliative measures were established due to a baseline end-stage condition. Five patients died, and four of them had a neoplasic condition as associated risk factor. Mortality in our series was 38.5%.

CONCLUSIONS

SMVT is a very rare disease that is often associated with neoplasic pathology, which influences its high mortality. Due to non specific symptoms, imaging is essential for the diagnosis and the detection of associated risk factors. In our series, computed tomography imaging was the most profitable test.