A Case of Superior Mesenteric Vein Thrombosis Caused by a Small Bowel Stricture After Conservative Treatment and Treated by Elective Surgery

Abstract

A 79-year-old man was admitted for abdominal pain, nausea and vomiting；an enhanced computed tomography (CT) examination revealed superior mesenteric and portal vein thrombosis. Since the CT examination also showed thickened small-intestine walls and ascites, but not intestinal necrosis, conservative therapy was started systemically. Anticoagulation therapy using heparin relieved the symptoms and reduced the thrombus, but one month later, the patient vomited because of intestinal stenosis. An enterography showed cicatricial stenosis at the upper jejunum and an intestine-intestine fistula. He was discharged 52 days after admission.We then conducted a partial intestine resection with an end-to-end anastomosis.The postoperative course was uneventful, and no recurrence was seen after subsequent edoxaban therapy. Superior mesenteric vein thrombosis is a comparatively rare disease, but intestinal stenosis can sometimes occur with conservative therapy. We controlled the ileus conservatively and performed surgery electively.