Surgical experience with ten mesenteric venous thrombosis patients

Experience is reported with surgical treatmen for mesenteric venous thrombosis in 10 patients during the 4-year period from 1988 through 1992. There were 6 male and 4 female patients, average age of 48.6 years. Associated medical conditions included two patients with liver cirrhosis, two patients of systemic lupus erythematus. Nephrotic syndrome, polycystic disease of liver and kidney, collagen disease, colon carcinoma, hypertension and bronchial asthma were noted in each of the remaining six patients. Presenting symptoms and signs were indolent and nonspecific at the initial stage but nine out of these ten patients had signs and symptoms of peritonitis when surgeons were consulted. Paracentesis appears to be of value in diagnosis according to the data. Operative procedures included laparotomy in two patients, bowel resection in six patients and bowel resection followed thrombectomy in two patients. Surgical mortality within one month was 40%. Complications in these survival patients included one patient with enterocutaneous fistula and one other patient with shorter bowel syndrome. Immediate and postoperative heparinization were given to eight patients, and postoperative anticoagulants were given for six months. More practice and studies are needed to increase ability to document mesenteric venous thrombosis and to define the therapeutic options.