Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9896
Peer-review started: June 9, 2021
First decision: June 25, 2021
Revised: July 5, 2021
Accepted: August 31, 2021
Article in press: August 31, 2021
Published online: November 16, 2021
Processing time: 153 Days and 11.9 Hours
Acute superior mesenteric venous thrombosis (MVT) is a rare condition associated with a high mortality rate. The treatment strategy for MVT is clinically challenging due to its insidious onset and rapid development, especially when accompanied by kidney transplantation.
Here we present a rare case of acute MVT developed 3 years after renal transplantation. A 49-year-old patient was admitted with acute abdominal pain and diagnosed as MVT with intestinal necrosis. An emergency exploratory laparotomy was performed to remove the infarcted segment of the bowel. Immediate systemic anticoagulation was also initiated. During the treatment, the patient experienced bleeding, anastomotic leakage, and sepsis. However, after aggressive treatment was administered, all thrombi were completely resolved, and the patient recovered with his renal graft function unimpaired.
The present case suggests that accurate diagnosis and timely surgical treatment are important to improve the survival rate of MVT patients. Bleeding with anastomotic fistula needs to be treated with caution because of grafts. Also, previously published cases of mesenteric thrombosis after renal transplantation were reviewed.
Core Tip: We present a rare case of acute superior mesenteric venous thrombosis developed 3 years after renal transplantation. Despite their infrequency, idiopathic acute mesenteric venous thrombosis with renal transplantation should be considered seriously. The accurate diagnosis and timely surgical treatment are very important to improve the survival rate of patients. Bleeding and anastomotic fistula during treatment need to be treated with caution because of grafts.