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Mesenteric vein thrombosis.
Medical expert of the article
Last reviewed: 04.07.2025
Mesenteric vein thrombosis can lead to acute intestinal ischemia. Symptoms of mesenteric vein thrombosis include the following:
- vague and poorly localized abdominal pain;
- bloating;
- diarrhea;
- subfebrile body temperature;
- increased pain and its localization in the epigastric or umbilical region, the appearance of symptoms of peritonitis, increasing leukocytosis - signs indicating the development of intestinal infarction;
- dilation of intestinal loops during plain radiography of abdominal organs.
Laparoscopy is currently used to diagnose all forms of acute mesenteric ischemia.
To identify mesenteric venous thrombosis, both angiography and plain radiography of the abdominal organs are used, revealing signs of small intestinal obstruction with dilated intestinal loops and gas levels in this pathology. However, angiography has a special diagnostic value. A complex of angiographic signs of mesenteric venous thrombosis has been described and is well known, including reflux of contrast medium into the aorta, spasm of the superior mesenteric artery and its branches, contrasting of only a few distal arterial branches, an increase in the duration of the arterial phase of more than 40 s, no contrasting of the superior mesenteric artery within 40 s, intense contrasting of the thickened wall of the colon, and penetration of contrast medium into the intestinal lumen. In cases where the patient's condition does not allow an angiographic examination, the diagnosis is established during laparotomy.
Mesenteric vein thrombosis is an urgent surgical disease and requires immediate surgery. According to available statistics, the mortality rate of patients operated within 12 hours from the onset of acute manifestations of the disease is 25%, when the operation is performed within 24-48 hours it increases to 72%. The absence of surgical treatment leads to death in 100% of cases.
During the operation, necrotic sections of the intestine are resected and thrombectomy is performed. The percentage of postoperative complications, which can be caused by inadequate removal of the inoperative section of the intestine, anastomotic insufficiency and sepsis, repeated thrombosis and intestinal infarction, remains high.
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