Analysis of therapeutic effects of 22 cases of mesenteric venous thrombosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LENG Rui ¹ , LI Chunmin ¹ , REN Hualiang ¹ , JIANG Huiping ² , ZHENG Yuehong ³ ,  ZHANG Wangde ¹

1. Department of Vascular Surgery, Beijing Chaoyang Hospital, Beijing 100020, R. P. China;
2. Department of Laboratory, The Thrid People’s Hospital of Heze, Heze, Shandong 274031, R. P. China;
3. Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing 100730, R. P. China;

Corresponding?author：

ZHANG Wangde, Email: drwangde@vip.sina.com

Keywords：

venous thrombosis; mesentery; open surgery; interventional thrombolytic therapy; anticoagulation therapy

DOI：

10.7507/1007-9424.202001017

Video：

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Objective To analyze the therapeutic effects of open surgery and endovascular treatment for mesenteric venous thrombosis.Methods The clinical data of 22 patients with mesenteric venous thrombosis from March 2005 to January 2014 were analyzed retrospectively. One patient underwent open surgery including removal of necrotic small intestine and thrombectomy of superior mesenteric vein immediately admission to the hospital. Five cases were treated with simple anticoagulation and cured. Sixteen cases received thrombolytic therapy after primary anticoagulant therapy.Results One case who underwent open surgery died of multiple organ failure at 72 h after the surgery. Five cases who received simple anticoagulant reached clinical relief finally. Sixteen patients who received thrombolytic therapy achieved recanalization totally or partially. Three cases died during follow-up (3 months to 7 years, average) of which 1 died of recurrence of acute superior mesenteric venous thrombosis, 1 died of myocardial infarction, and 1 died of stroke.Conclusions For patients with symptomatic mesenteric venous thrombosis, if there is no intestinal necrosis, there will be encouraging results by interventional thrombolytic therapy. And the treatment effect needs further experience accumulation in more cases.

Citation： LENG Rui, LI Chunmin, REN Hualiang, JIANG Huiping, ZHENG Yuehong, ZHANG Wangde. Analysis of therapeutic effects of 22 cases of mesenteric venous thrombosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(10): 1245-1248. doi: 10.7507/1007-9424.202001017 Copy

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12.	Hollingshead M, Burke CT, Mauro MA, <italic>et al</italic>. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis. J Vasc Interv Radiol, 2005, 16(5): 651-661.
13.	Yang S, Zhang L, Liu K, <italic>et al</italic>. Postoperative catheter-directed thrombolysis <italic>versus</italic> systemic anticoagulation for acute superior mesenteric venous thrombosis. Ann Vasc Surg, 2016, 35: 88-97.
14.	Hmoud B, Singal AK, Kamath PS. Mesenteric venous thrombosis. J Clin Exp Hepatol, 2014, 4(3): 257-263.
15.	Wijaya R, Ng JH, See AH, <italic>et al</italic>. Open thrombectomy for primary acute mesentericoportal venous thrombosis--should it be done? Ann Vasc Surg, 2015, 29(7): 1421-1454.

1. Lock G. Acute mesenteric ischemia: classification, evaluation and therapy. Acta Gastroenterol Belg, 2002, 65(4): 220-225.
2. 楊玲飛, 許俊, 劉小孫, 等. 急性腸系膜上靜脈血栓形成的治療及預后因素分析. 中華普通外科雜志, 2016, 31(2): 100-103.
3. Elliot JW. Ⅱ. The operative relief of gangrene of intestine due to occlusion of the mesenteric vessels. Ann Surg, 1895, 21(1): 9-23.
4. Jonas J, Bottger T. Diagnosis and prognosis of mesenterial infarct. Med Klin (Munich), 1994, 89(2): 68-72.
5. 陳浩, 肖占祥. 急性腸系膜靜脈血栓形成的診療策略. 中國血管外科雜志(電子版), 2019, 11(1): 7-9.
6. Russell CE, Wadhera RK, Piazza G. Mesenteric venous thrombosis. Circulation, 2015, 131(18): 1599-1603.
7. Montagnana M, Danese E, Lippi G. Biochemical markers of acute intestinal ischemia: possibilities and limitations. Ann Transl Med, 2018, 6(17): 341.
8. van den Heijkant TC, Aerts BA, Teijink JA, <italic>et al</italic>. Challenges in diagnosing mesenteric ischemia. World J Gastroenterol, 2013, 19(9): 1338-1341.
9. Harnik IG, Brandt LJ. Mesenteric venous thrombosis. Vasc Med, 2010, 15(5): 407-418.
10. Condat B, Pessione F, Helene DM, <italic>et al</italic>. Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology, 2000, 32(3): 466-470.
11. da Motta Leal Filho JM, Santos AC, Carnevale FC, <italic>et al</italic>. Infusion of recombinant human tissue plasminogen activator through the superior mesenteric artery in the treatment of acute mesenteric venous thrombosis. Ann Vasc Surg, 2011, 25(6): 840. e1-e4.
12. Hollingshead M, Burke CT, Mauro MA, <italic>et al</italic>. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis. J Vasc Interv Radiol, 2005, 16(5): 651-661.
13. Yang S, Zhang L, Liu K, <italic>et al</italic>. Postoperative catheter-directed thrombolysis <italic>versus</italic> systemic anticoagulation for acute superior mesenteric venous thrombosis. Ann Vasc Surg, 2016, 35: 88-97.
14. Hmoud B, Singal AK, Kamath PS. Mesenteric venous thrombosis. J Clin Exp Hepatol, 2014, 4(3): 257-263.
15. Wijaya R, Ng JH, See AH, <italic>et al</italic>. Open thrombectomy for primary acute mesentericoportal venous thrombosis--should it be done? Ann Vasc Surg, 2015, 29(7): 1421-1454.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of therapeutic effects of 22 cases of mesenteric venous thrombosis

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