Mesenteric venous thrombosis in a young adult: A case report and review of the literature.

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING World journal of radiology Pub Date : 2024-10-28 DOI:10.4329/wjr.v16.i10.569
Jiao-Jiao Yuan, Hai-Fu Zhang, Jian Zhang, Jun-Zhi Li
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Abstract

Background: Acute mesenteric vein thrombosis (MVT) accounts for only 2%-10% of all cases of acute mesenteric ischaemia, with an incidence rate of ~0.1% in Europe and the United States. It represents < 10% of mesenteric infarction cases and is seen predominantly in older adults. In younger individuals, MVT is uncommon, with 36% of cases having unidentified mechanisms and causes.

Case summary: A 27-year-old man presented to the emergency department on February 29, 2024, with a chief complaint of intermittent abdominal pain for 3 day. He was previously in good health. As the abdominal pain was not alleviated by conventional treatment, an abdominal computed tomography (CT) scan was performed, which showed increased density in the portal and mesenteric veins. Further imaging, including portal vein ultrasound, mesenteric CT angiography, and enhanced abdominal CT, revealed widespread thrombosis of the portal vein system (including the main portal vein, left and right branches, proximal mesenteric vein, and splenic vein). After 10 day of thrombectomy and anticoagulation therapy, the patient's abdominal pain had improved significantly. Follow-up assessments indicated that portal venous blood flow had largely returned to normal. He was discharged on March 9, 2024. During a follow-up exam 2 months later, repeat abdominal enhanced CT showed that the previously detected thrombi were no longer visible.

Conclusion: Clinicians should remain vigilant for acute MVT in young patients presenting with abdominal pain, to prevent misdiagnosis of this fatal condition.

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一名年轻成年人的肠系膜静脉血栓形成:病例报告和文献综述。
背景:急性肠系膜静脉血栓(MVT)仅占急性肠系膜缺血病例的 2%-10%,在欧洲和美国的发病率约为 0.1%。它在肠系膜梗死病例中的占比小于 10%,主要见于老年人。病例摘要:一名 27 岁男子于 2024 年 2 月 29 日到急诊科就诊,主诉为间歇性腹痛 3 天。他之前健康状况良好。由于常规治疗无法缓解腹痛,他接受了腹部计算机断层扫描(CT),结果显示门静脉和肠系膜静脉密度增高。进一步的成像检查,包括门静脉超声、肠系膜 CT 血管造影和增强腹部 CT,发现门静脉系统(包括门静脉主干、左右分支、肠系膜近端静脉和脾静脉)广泛血栓形成。经过 10 天的血栓切除和抗凝治疗,患者的腹痛明显好转。随访评估显示,门静脉血流已基本恢复正常。他于 2024 年 3 月 9 日出院。在 2 个月后的随访检查中,腹部增强 CT 显示之前发现的血栓已不复存在:临床医生应该对腹痛的年轻患者的急性 MVT 保持警惕,以防误诊为这一致命疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
8.00%
发文量
35
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