Abstract:

Objective

To explore the diagnosis and treatment of superior mesenteric venous thrombosis (SMVT).

Methods

Clinical datum of 18 cases with SMVT from Jan 1997 to Dec 2006 were retrospectively analyzed.All patients accepted color Doppler ultrasonography,12 cases of them with post-contrast CT scan,1 case of them with selective superior mesenteric arterigraphy.15 patients with the acute abdominal disease underwent operative treatment.3 cases without the acute abdominal disease were treated with non-surgical management.

Results

The detectable rate of color Doppler ultrasonography and CT for SMVT was 77.8%and 100%respectively. 15 cases were accepted with operation,12 of them were cured,3 cases died of poisoned shock and multiple organic failure after operation.3 cases treated with non-surgical management were cured.For the cured 15 cases,there was no recurrence of SMVT in following up for six months to three years.

Conclusion

Slow portal vein flow,super abdominal operation involving portal vein system and high-coagulated blood are the common inducement of SMVT.Post-contrast CT scan is very important to early diagnosis and differential diagnosis of SMVT.Early anti-coagulated and thrombosis-dissolved treatment can increase the survival rate of SMVT patients.Emergency operation is demanded for the patients displayed with the acute abdominal disease.Prolongation of anti-coagulated and thrombosis-dissolved treatment after operation plays the importantrole for dissolving the remnant thrombosis in superior mesenteric vein and preventing the recurrence of SMVT.

Key words: Superior mesenteric vein, Thrombosis, Diagnosis, Treatment