International Journal of Anatomy Radiology and Surgery (Jul 2024)
Clinical Profile and Management of Patients with Superior Mesenteric Vein ThrombosisA Descriptive Study from Southern India
Abstract
Introduction: Abdominal pain is the most common presenting complaint in any Emergency Department. Superior Mesenteric Vein Thrombosis (SMVT) is a very rare condition, a surgical emergency seen in the elderly population with a high mortality rate. Aim: To assess the clinical profile, risk factors, radiological findings, management and outcome of patients presenting with SMVT. Materials and Methods: A retrospective descriptive study was conducted in the Department of General Surgery, Father Muller Medical College, Mangaluru, Karnataka, India, from January 2018 to December 2022. Hospital data and case files were analysed and parameters such as age group, sex distribution, presenting features, management and outcomes were recorded. Statistical analysis of the data was done using Excel 2021 (Microsoft 365), and the data was described in numbers and percentages. Results: A total of 10 patients were included, with a predominance of male patients, of which 6 (60%) were males and 4 (40%) were females. Eight patients had associated co-morbidities. Among the 10 patients, 4 (40%) were diagnosed with malignancies (three pancreatic, one liver secondary), 2 (20%) patients were on oral contraceptive pills. Two (20%) patients developed SMVT after intra-abdominal surgery following trauma, two had a history of Distal Venous Thrombosis (DVT) and pre-existing portal hypertension were identified as causative factors. The majority, 6 (60%) of patients, presented within 48 hours of the onset of pain and vomiting. Computed Tomography (CT) angiography was the diagnostic test used in all patients (100%). Anticoagulation was initiated in all patients, and three patients underwent surgery for complications associated with the condition. Out of the 10 patients, 3 (30%) died during treatment, while 7 out of 10 (70%) had a good recovery. Within one year of follow-up, four patients out of the seven deceased. Conclusion: Acute mesenteric venous thrombosis is observed in the elderly population with multiple co-morbidities. Early presentation to the hospital with appropriate clinical and radiological investigations helps in reducing mortality.
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