Acute mesenteric venous thrombosis: Improved outcome with early diagnosis and prompt anticoagulation therapy
| Autor: | M. Ghulam, A Rehman Alvi, Sadaf Khan, Shahida Bibi, Samiullah Khan Niazi |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Exploratory laparotomy medicine.medical_treatment Peritonitis Thrombophilia Statistics Nonparametric Gangrene Acute mesenteric ischemia Laparotomy medicine Humans Mesentery Protein S deficiency Retrospective Studies Venous Thrombosis Chi-Square Distribution business.industry Heparin Antithrombin III deficiency Anticoagulants Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Mesenteric ischemia Exact test Early Diagnosis Treatment Outcome Acute Disease Female business Tomography X-Ray Computed Acute mesenteric venous thrombosis |
| Zdroj: | International Journal of Surgery. 7(3):210-213 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2009.03.002 |
| Popis: | AimTo analyze the clinical spectrum of acute mesenteric venous thrombosis (AMVT), to assess the factors affecting the outcome and to determine the optimal management of this disease.MethodsWe retrospectively reviewed the case records of 20 patients with acute mesenteric venous thrombosis confirmed on CT imaging or on laparotomy over a 23year period. Patients were divided into two groups according to the duration of symptoms: group I with symptoms for up to 3days duration and group II with symptoms for more than 3days.ResultsThe mean age was 50.55year, with 15 male and five female patients. In all patients the diagnosis were confirmed on CT imaging preoperatively except two patients when the diagnosis was established on exploratory laparotomy in the period before 1998. There were six patients in group I and 14 in group II. Five patients underwent an operation and one received a non-operative treatment in group I. Three patients underwent laparotomy and 11 received non-operative treatment in group II (P-value 0.01, Fisher's exact test). There were three and one mortality in groups I (n=6) and II (n=14) respectively (P-value 0.061, Fisher's exact test). Most patients received preoperative therapeutic anticoagulation. Two patients in group II who underwent exploratory laparotomy, neither did receive preoperative anticoagulation. Both patients died in the postoperative period.Eighteen patients were investigated for thrombophilia. Eleven patients had one (n=6) or more (n=5) identifiable hypercoagulable state, these included protein S deficiency (n=1), both protein C and S deficiency (n=5), polycythemia (n=2), factor V Leiden deficiency (n=1) and malignancy (n=2). None had antithrombin III deficiency, hyperhomocystine urea and contraceptive pill intake. There were no statistical differences between thrombophilic and non-thrombophilic patients regarding duration of symptoms, indications for laparotomy and 30days mortality rate.ConclusionsPatients with AMVT of rapid onset ( |
| Databáze: | OpenAIRE |
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