[Mesenteric venous thrombosis (MVT): a problem in diagnosis and management]

Abstract

The mesenterial venous thrombosis is a rare and independent cause of intestinal ischemia. 5 to 15% of all intestinal ischemias are due to venous problems. The lack of specific clinical symptoms and laboratory data often leads to a delayed diagnosis with irreversible intestinal infarction. Only by thorough searching by means of modern diagnostic devices is it possible to make an early diagnosis and treat the ischemic situation timely. Several therapeutical options are at hand. A timely and adequate application of these aids mostly depends on the clinical experience of the medical team as well as on an optimal interdisciplinary collaboration (radiology, hematology, angiology, gastroenterology, surgery). We want to analyze the problems related to diagnostics and management on the basis of 2 cases with different manifestations of a mesenterial venous thrombosis. We ascertain that: (1) the enhanced-CT analysis and/or the duplex-sonography mostly lead to a diagnosis, (2) the prognosis benefits from an immediate heparinization, (3) the request for large-scale intestinal resection, keeping a safety-space, has been replaced by the technique of limited resection, followed by earlier second-look-operations.