Document Detail

Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation.
MedLine Citation:
PMID:  11851847     Owner:  NLM     Status:  MEDLINE    
Mesenteric vein thrombosis is generally difficult to diagnose and can be fatal. A case of extensive thrombosis of the mesenteric and portal veins was diagnosed early and successfully treated in a 26-year-old man with Down syndrome who was admitted to hospital because of abdominal pain, severe nausea and high fever. Ultrasonography revealed moderate ascites, and there was minimal flow in the portal vein (PV) on the Doppler examination. Computed tomography (CT) showed remarkable thickening of the walls of the small intestine and extensive thrombosis of the mesenteric, portal and splenic veins. Because neither intestinal infarction nor peritonitis was seen, combined thrombolysis and anticoagulation therapy without surgical treatment was chosen. Urokinase was administered intravenously and later through a catheter in the superior mesenteric artery. Heparin and antibiotics were given concomitantly. The patient's symptoms and clinical data improved gradually. After 10 days, CT revealed that collateral veins had developed and the thrombi in the distal portions of the mesenteric veins had dissolved, although the main trunk of the PV had not recanalized. The only risk factor of thrombosis that was detected was decreased protein S activity.
A Tateishi; H Mitsui; T Oki; J Morishita; H Maekawa; N Yahagi; T Maruyama; M Ichinose; S Ohnishi; Y Shiratori; M Minami; S Koutetsu; N Hori; T Watanabe; H Nagawa; M Omata
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  16     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-02-19     Completed Date:  2002-03-12     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1429-33     Citation Subset:  IM    
Departments of Gastroenterology, Radiology and Surgical Oncology, University of Tokyo, Tokyo, Japan.
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MeSH Terms
Down Syndrome / complications*
Fibrinolytic Agents / therapeutic use*
Heparin / administration & dosage,  therapeutic use
Mesenteric Vascular Occlusion / drug therapy*,  etiology,  radiography
Mesenteric Veins / radiography
Plasminogen Activators / therapeutic use
Portal Vein* / radiography
Protein S Deficiency / etiology
Thrombolytic Therapy / methods*
Urokinase-Type Plasminogen Activator / therapeutic use
Venous Thrombosis / drug therapy*,  etiology,  radiography
Reg. No./Substance:
0/Fibrinolytic Agents; 9005-49-6/Heparin; EC 3.4.21.-/Plasminogen Activators; EC Plasminogen Activator

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