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Clinical Manifestations of Superior Mesenteric Venous Thrombosis in the Era of Computed Tomography
Vascular Specialist International 2018;34:83-87
Published online December 31, 2018;  https://doi.org/10.5758/vsi.2018.34.4.83
© 2018 Vascular Specialist International.

Joon Whoi Cho1, Jae Jeong Choi2, Eunhae Um1, Sung Min Jung1, Yong Chan Shin1, Sung-Won Jung1, Jae Il Kim1, Pyong Wha Choi1, Tae Gil Heo1, Myung Soo Lee1, and Heungman Jun1

1Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea, 2Inje University College of Medicine, Busan, Korea
Correspondence to: Corresponding author: Heungman Jun, Department of Surgery, Ilsan Paik, Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea, Tel: 82-31-910-4947, Fax: 82-31-910-7784, E-mail: junh@paik.ac.kr, https://orcid.org/0000-0003-2530-4388
Received May 28, 2018; Revised August 14, 2018; Accepted September 11, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Purpose

Thrombosis of the portal vein, known as pylephlebitis, is a rare and fatal complication caused by intraperitoneal infections. The disease progression of superior mesenteric venous thrombosis (SMVT) is not severe. This study aimed to determine the clinical features, etiology, and prognosis of SMVT.

Materials and Methods

We retrospectively reviewed the medical records of 41 patients with SMVT from March 2000 to February 2017. We obtained a list of 305 patients through the International Classification of Disease-9 code system and selected 41 patients with SMVT with computed tomography. Data from the medical records included patient demographics, comorbidities, review of system, laboratory results, clinical courses, and treatment modalities.

Results

The causes of SMVT were found to be intraperitoneal inflammation in 27 patients (65.9%), malignancy in 7 patients (17.1%), and unknown in 7 patients (17.1%). Among the patients with intraperitoneal inflammation, 14 presented with appendicitis (51.9%), 7 with diverticulitis (25.9%), and 2 with ileus (7.4%). When comparing patients with and without small bowel resection, the differences in symptom duration, bowel enhancement and blood culture were significant (P=0.010, P=0.039, and P=0.028, respectively).

Conclusion

SMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis. In addition, rapid symptom progression and positive blood culture can be the prognostic factors related to extensive bowel resection. Use of appropriate antibiotics and understanding of disease progression can help improve the outcomes of patients with SMVT.

Keywords: Mesenteric ischemia, Vascular insufficiency mesenteric