Anticoagulation and delayed bowel resection in the management of mesenteric venous thrombosis

Abstract

Acute mesenteric venous thrombosis is potentially lethal because it can result in mesenteric ischemia and, ultimately, bowel infarction requiring surgical intervention. Systemic anticoagulation for the prevention of thrombus propagation is a well-recognized treatment modality and the current mainstay therapy for patients with acute mesenteric venous thrombosis. However, the decision between prompt surgical exploration vs conservative treatment with anticoagulation is somewhat difficult in patients with suspected bowel ischemia. Here we describe a patient with acute mesenteric venous thrombosis who presented with bowel ischemia and was treated with anticoagulation and delayed short-segment bowel resection.

Keywords: Thrombosis; Mesenteric vein; Anticoagulation; Small intestine; Resection

Core tip: Recently, we experienced a patient with acute mesenteric venous thrombosis who presented with bowel ischemia and was treated with anticoagulation and delayed short-segment bowel resection. The decision between prompt surgical exploration or conservative treatment with anticoagulation in patients with suspected bowel ischemia is difficult and one of the main purpose is the preservation of bowel. So, in equivocal patients, anticoagulation for potentially reversible bowel ischemia and delayed bowel resection for stricture if developed could be an appropriate management technique to prevent or limit future bowel resection.