Faculty Collaboration Database

Mesenteric venous thrombosis in inflammatory bowel disease. J Clin Gastroenterol 2005 Jan;39(1):27-31

Date

12/16/2004

Pubmed ID

15599206

Scopus ID

2-s2.0-11144319481 (requires institutional sign-in at Scopus site)   69 Citations

Abstract

Mesenteric venous thrombosis (MVT) is a rare but potentially catastrophic clinical complication, which may lead to ischemia or infarction of the intestine and/or the emergence of portal hypertension. An association between inflammatory bowel disease (IBD) and MVT has previously been described, but clinical factors that may contribute to this complication in the setting of IBD are not well characterized. Diagnosis of MVT in IBD is difficult, as patients frequently present with nonspecific abdominal discomfort, which may delay diagnosis and initiation of treatment. We report 6 of 545 IBD patients at our center (1.1%) that developed MVT, and describe presentation, diagnostic approaches, treatment options, underlying contributing factors, and outcome. The diagnosis was determined with abdominal computed tomography (CT) in 5 of 6 cases. Clinical factors, which were thought to contribute to MVT, included underlying hypercoagulability, low-flow state, uncontrolled inflammation, perioperative time period, and prior surgical manipulation of the portal vein following orthotopic liver transplantation. There were no deaths as a result of MVT, although 1 patient developed severe portal hypertension and another experienced intestinal infarction requiring extensive resection. We conclude that MVT is an important clinical consideration in IBD patients, specifically during the perioperative setting, and diagnosis is facilitated with the use of CT scan.

Author List

Hatoum OA, Spinelli KS, Abu-Hajir M, Attila T, Franco J, Otterson MF, Telford GL, Binion DG

Author

Mary F. Otterson MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Humans
Inflammatory Bowel Diseases
Male
Mesenteric Vascular Occlusion
Mesenteric Veins
Middle Aged
Retrospective Studies
Venous Thrombosis