Yuan JJ, Zhang HF, Zhang J, Li JZ. Mesenteric venous thrombosis in a young adult: A case report and review of the literature. World J Radiol 2024; 16(10): 569-578 [PMID: 39494142 DOI: 10.4329/wjr.v16.i10.569]
Corresponding Author of This Article
Jun-Zhi Li, Chief Doctor, Professor, Department of Emergency Medicine, Ninth Hospital of Xi'an, No. 151 Dongduan Nanerhuan, Beilin District, Xi’an 710000, Shaanxi Province, China. hess2009@126.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2024; 16(10): 569-578 Published online Oct 28, 2024. doi: 10.4329/wjr.v16.i10.569
Mesenteric venous thrombosis in a young adult: A case report and review of the literature
Jiao-Jiao Yuan, Hai-Fu Zhang, Jian Zhang, Jun-Zhi Li
Jiao-Jiao Yuan, Jian Zhang, Jun-Zhi Li, Department of Emergency Medicine, Ninth Hospital of Xi'an, Xi’an 710000, Shaanxi Province, China
Hai-Fu Zhang, Department of Vascular Intervention, Ninth Hospital of Xi'an, Xi’an 710000, Shaanxi Province, China
Co-first authors: Jiao-Jiao Yuan and Hai-Fu Zhang.
Co-corresponding authors: Jiao-Jiao Yuan and Jun-Zhi Li.
Author contributions: Yuan JJ and Li JZ drafted the conception and design of the study; Yuan JJ wrote the article; Zhang HF participated in data collection and organization; Zhang J handled image sorting and summarization; Yuan JJ and Zhang HF made crucial and indispensable contributions towards the completion of the study and were thus qualified as the co-first authors of the paper. Li JZ and Yuan JJ revised the article; Li JZ and Yuan JJ provided final approval for the version submitted for publication. All authors have read and approved the final manuscript. The collaboration between Yuan JJ and Li JZ as the co-corresponding authors is crucial for the publication of this manuscript. Yuan JJ searched the literature, and drafted, revised, and submitted the early version of the manuscript. Li JZ supervised the whole process of the study, was instrumental and responsible for data re-analysis and re-interpretation, and revised the article.
Informed consent statement: Informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no competing interests to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Zhi Li, Chief Doctor, Professor, Department of Emergency Medicine, Ninth Hospital of Xi'an, No. 151 Dongduan Nanerhuan, Beilin District, Xi’an 710000, Shaanxi Province, China. hess2009@126.com
Received: May 14, 2024 Revised: August 22, 2024 Accepted: September 6, 2024 Published online: October 28, 2024 Processing time: 166 Days and 23.8 Hours
Abstract
BACKGROUND
Acute mesenteric vein thrombosis (MVT) accounts for only 2%–10% of all cases of acute mesenteric ischaemia, with an incidence rate of ~0.1% in Europe and the United States. It represents < 10% of mesenteric infarction cases and is seen predominantly in older adults. In younger individuals, MVT is uncommon, with 36% of cases having unidentified mechanisms and causes.
CASE SUMMARY
A 27-year-old man presented to the emergency department on February 29, 2024, with a chief complaint of intermittent abdominal pain for 3 day. He was previously in good health. As the abdominal pain was not alleviated by conventional treatment, an abdominal computed tomography (CT) scan was performed, which showed increased density in the portal and mesenteric veins. Further imaging, including portal vein ultrasound, mesenteric CT angiography, and enhanced abdominal CT, revealed widespread thrombosis of the portal vein system (including the main portal vein, left and right branches, proximal mesenteric vein, and splenic vein). After 10 day of thrombectomy and anticoagulation therapy, the patient’s abdominal pain had improved significantly. Follow-up assessments indicated that portal venous blood flow had largely returned to normal. He was discharged on March 9, 2024. During a follow-up exam 2 months later, repeat abdominal enhanced CT showed that the previously detected thrombi were no longer visible.
CONCLUSION
Clinicians should remain vigilant for acute MVT in young patients presenting with abdominal pain, to prevent misdiagnosis of this fatal condition.
Core Tip: Acute mesenteric venous thrombosis accounts for < 10% of mesenteric infarction cases. It is rare in younger individuals, with unidentified mechanisms and causes in 36% of the cases. This case report provides a detailed description of a 27-year-old man diagnosed with acute mesenteric vein thrombosis. The rarity of this condition in younger patients and the critical importance of early diagnosis for clinical decision-making are highlighted. Our aim is to enhance clinicians' awareness of acute mesenteric vein thrombosis in young patients presenting with abdominal pain, to prevent the potentially fatal consequences of a missed diagnosis.
