Mesenteric venous thrombosis. Associated systemic disorders and hypercoagulability status of 21 surgical patients

Abstract

BACKGROUND/AIMS: Mesenteric venous thrombosis (MVT) is a rare condition with a challenging diagnosis. The aim of this study was to evaluate its association with systemic diseases and coagulation disorders.

METHODOLOGY: Out of 132 patients operated on because of mesenteric ischemia between 1988 and 2002, all patients with a documented MVT were retrospectively recorded. Epidemiological and clinical data, complications and perioperative mortality were analyzed.

RESULTS: Twenty-one patients, 10 male and 11 female, had MVT. Mean age was 63.8 years (SD: +/- 20.9). Arterial hypertension (57.1%) was the most prevalent associated condition. Other associated disorders were neoplasms (3 cases), liver cirrhosis (1 case), recurrent pulmonary thromboembolism (1 case), and one or more coagulation disorders (7 cases): lupus anticoagulant (2 cases); factor V Leiden (2 cases); protein S deficiency (3 cases); antithrombin III deficiency (1 case) and disseminated intravascular coagulation (1 case). Perioperative mortality was 33.3% (7 patients). Mean survival at the end of the study was 65.73 months (EE: 13.82). Patients with a coagulation disorder had a higher survival rate than those presenting without it (p = 0.02).

CONCLUSIONS: MVT is still a lethal condition with a high morbidity that could be associated to systemic disorders and hypercoagulability syndromes in more than 50% of the cases.