Acute appendicitis complicated by mesenteric vein thrombosis: A case report

doi:10.12998/wjcc.v9.i36.11400

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Dec 26, 2021; 9(36): 11400-11405
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11400

Acute appendicitis complicated by mesenteric vein thrombosis: A case report

Fan Yang, Xiao-Chao Guo, Xiao-Long Rao, Lie Sun, Ling Xu

Fan Yang, Lie Sun, Department of General Surgery, Peking University First Hospital, Beijing 100034, Beijing Province, China

Xiao-Chao Guo, Department of Radiology, Peking University First Hospital, Beijing 100034, Beijing Province, China

Xiao-Long Rao, Endoscopy Center, Peking University First Hospital, Beijing 100034, Beijing Province, China

Ling Xu, Breast Disease Center, Peking University First Hospital, Beijing 100034, Beijing Province, China

Author contributions: Yang F drafted the initial manuscript, revised the final manuscript as submitted, and collected clinical data; Guo XC provided the image data and the description of them; Rao XL contributed to the image finding; Xu L was involved in revising and polishing the text; and Sun L took responsibility for the paper as a whole and help collect the patient's data.

Informed consent statement: We have obtained the oral consent of the patient and her family before submitting the manuscript. The case report does not involve the patient’s private information and we can provide informed consent when necessary.

Conflict-of-interest statement: The authors have no conflict of interest to declare.

CARE Checklist (2016) statement: We have filled out the CARE Checklist (2016) and uploaded the completed file at the first time we submitted the manuscript.

Corresponding author: Lie Sun, MD, Associate Chief Physician, Surgeon, Department of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany, Baden 89081 Ulm, Germany. sunliemd@126.com

Received: June 13, 2021
Peer-review started: June 13, 2021
First decision: June 25, 2021
Revised: June 29, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 26, 2021
Processing time: 192 Days and 22.3 Hours

Abstract

BACKGROUND

Acute appendicitis with mesenteric vein thrombosis (MVT) is an uncommon condition and usually lacks specific clinical manifestations, which leads to a high rate of misdiagnosis or delayed diagnosis, especially when it is accompanied by other abdominal diseases. Prompt and accurate recognition is vital for treatment and prognosis.

CASE SUMMARY

A 37-year-old woman had a history of acute metastatic right lower abdominal pain, nausea, and fever. A contrast-enhanced computed tomography (CT) scan showed a filling defect in the mesenteric vessels. The patient was diagnosed with acute appendicitis complicated by MVT and was treated with anticoagulation and intravenous antibiotics. The follow-up CT scan showed full resolution of the thrombosis and inflammation.

CONCLUSION

Clinical awareness is essential for recognizing MVT, especially when it is accompanied by other common acute abdominal diseases, such as acute appendicitis. Contrast-enhanced CT is helpful for the diagnosis of MVT and is recommended for patients with acute abdominal diseases.

Keywords: Mesenteric vein thrombosis; Ischemic bowel disease; Acute abdominal diseases; Contrast-enhanced computed tomography; Acute appendicitis; Case report

Core Tip: The article presents an uncommon clinical case of mesenteric vein thrombosis (MVT) complicated by acute appendicitis in a patient with no obvious risk factors for thrombosis. The patient was diagnosed correctly at an early stage and finally recovered after receiving anticoagulation and antibiotics. MVT is rare and difficult to recognize when it occurs with other acute abdominal diseases. Contrast-enhanced computed tomography is vital to its diagnosis. Therefore, clinicians should fully consider the possibility of this disease when treating patients with acute abdominal diseases and use appropriate diagnostic tests.