A CASE OF SUPERIOR MESENTERIC VEIN THROMBOSIS CAUSING SMALL BOWEL STRICTURE 2 MONTHS AFTER INTRAARTERIAL THROMBOLYTIC METHOD

Abstract

This paper deals with a case of superior mesenteric vein thrombosis diagnosed by an abdominal CT scan, causing small bowel stricture 2 months after intraarterial thrombolytic method with resultant symptomatic remission, which demanded a laparotomy.
A 68-year-old man was brought to the hospital with a 7-day history of increasing nausea, vomiting. Contrast-enhanced CT scanning comfirmed mesenteric venous thrombosis. An arteriogram was obtained with injections into the superior mesentery, and the patient was given urokinase 240, 000 units daily for 5 consecutive days through an endhole catheter. The patient appeared stable without any symptoms. On the following day, 2 months after the therapy, the patient became worse with increasing pain and nausea. Partial resection of the small intestine was performed. Resected specimen showed severe stenosis 5 cm in length with necrotic change in the ileum. Microscopically, penetrated ulcer with granulomatous panniculitis and submucosal hemorrhage were observed. Postoperative course was uneventful.