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.	陳建立, 張國志, 常艷, 等.急性腸系膜靜脈血栓臨床特點及預后影響因素分析.中國全科醫學, 2012, 15(9): 1043-1044.
4.	陳玉強, 常艷, 李頤紅, 等.早期診斷和迅速抗凝治療對急性腸系膜靜脈血栓的意義.河北醫藥, 2013, 35(9): 1376-1377.
5.	戴曉剛, 王建宏, 李樹鈞, 等.急性腸系膜靜脈血栓形成26例診治體會.內科急危重癥雜志, 2012, 18(5): 285-287.
6.	孫力勇, 王晨龍, 朱金明, 等. 13例急性腸系膜靜脈血栓臨床診治分析.實用醫藥雜志, 2015, 32(11): 1002-1003.
7.	Yanar F, A?cao?lu O, G?k 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.	黃智勇.能量多普勒超聲在腸系膜靜脈血栓形成中的診斷價值.中國實用醫刊, 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.	周倩靜, 張桃, 嚴偉弘, 等.多層CT在診斷原發性急性腸系膜缺血中的價值.中國CT和MRI雜志, 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.	陳雄.經皮肝穿刺門靜脈置管溶栓治療急性腸系膜上靜脈血栓(附7例報道).中國普外基礎與臨床雜志, 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.	楊碩菲, 吳性江, 黎介壽, 等.急性腸系膜上靜脈血栓的進階式診治.中華胃腸外科雜志, 2014, 17(5): 516-520.
18.	王德剛.急性腸系膜靜脈血栓術后抗凝溶栓的療效評價.醫學美學美容(中旬刊), 2014, (10): 666-667.
19.	李世權, 康振華, 閆國強, 等.急性腸系膜上靜脈血栓形成診斷與治療.中國老年學雜志, 2015, 35(17): 5037-5039.
20.	屈衛龍.腸系膜靜脈血栓形成的診斷與手術治療.中國保健營養(中旬刊), 2013, (5): 734.
21.	彭文生, 嚴立平, 朱春英, 等.腸系膜靜脈血栓診治分析.中外健康文摘, 2012, 9(2): 63-64.
22.	劉永所.腸系膜上靜脈血栓形成引起的腹膜炎手術治療體會.世界最新醫學信息文摘, 2014, 14(23): 45.
23.	田延鋒, 劉學剛, 吳國斌, 等.原發性腸系膜靜脈血栓形成3例報道.中國普外基礎與臨床雜志, 2006, 13(6): 680.
24.	徐健, 陳建華, 夏茜, 等.腸系膜上靜脈血栓形成致腸壞死的診治分析(附32例報道), 中國普外基礎與臨床雜志, 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. 陳建立, 張國志, 常艷, 等.急性腸系膜靜脈血栓臨床特點及預后影響因素分析.中國全科醫學, 2012, 15(9): 1043-1044.
4. 陳玉強, 常艷, 李頤紅, 等.早期診斷和迅速抗凝治療對急性腸系膜靜脈血栓的意義.河北醫藥, 2013, 35(9): 1376-1377.
5. 戴曉剛, 王建宏, 李樹鈞, 等.急性腸系膜靜脈血栓形成26例診治體會.內科急危重癥雜志, 2012, 18(5): 285-287.
6. 孫力勇, 王晨龍, 朱金明, 等. 13例急性腸系膜靜脈血栓臨床診治分析.實用醫藥雜志, 2015, 32(11): 1002-1003.
7. Yanar F, A?cao?lu O, G?k 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. 黃智勇.能量多普勒超聲在腸系膜靜脈血栓形成中的診斷價值.中國實用醫刊, 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. 周倩靜, 張桃, 嚴偉弘, 等.多層CT在診斷原發性急性腸系膜缺血中的價值.中國CT和MRI雜志, 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. 陳雄.經皮肝穿刺門靜脈置管溶栓治療急性腸系膜上靜脈血栓(附7例報道).中國普外基礎與臨床雜志, 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. 楊碩菲, 吳性江, 黎介壽, 等.急性腸系膜上靜脈血栓的進階式診治.中華胃腸外科雜志, 2014, 17(5): 516-520.
18. 王德剛.急性腸系膜靜脈血栓術后抗凝溶栓的療效評價.醫學美學美容(中旬刊), 2014, (10): 666-667.
19. 李世權, 康振華, 閆國強, 等.急性腸系膜上靜脈血栓形成診斷與治療.中國老年學雜志, 2015, 35(17): 5037-5039.
20. 屈衛龍.腸系膜靜脈血栓形成的診斷與手術治療.中國保健營養(中旬刊), 2013, (5): 734.
21. 彭文生, 嚴立平, 朱春英, 等.腸系膜靜脈血栓診治分析.中外健康文摘, 2012, 9(2): 63-64.
22. 劉永所.腸系膜上靜脈血栓形成引起的腹膜炎手術治療體會.世界最新醫學信息文摘, 2014, 14(23): 45.
23. 田延鋒, 劉學剛, 吳國斌, 等.原發性腸系膜靜脈血栓形成3例報道.中國普外基礎與臨床雜志, 2006, 13(6): 680.
24. 徐健, 陳建華, 夏茜, 等.腸系膜上靜脈血栓形成致腸壞死的診治分析(附32例報道), 中國普外基礎與臨床雜志, 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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