Abstract
A 32-year-old man was referred to our hospital because of left abdominal pain. Under the diagnosis of acute peritonitis by palpation and CT findings, emergency laparotomy was performed. Operative findings revealed superior mesenteric venous thrombosis with local eruption in the ileum. The ileal lesion was resected with end to end anastomosis. Three days after the operation, he complained of severe abdominal pain and CT showed edema of the small intestine and ascites. A reoperation revealed recurrence of the thrombosis, and the same procedure as the first operation was performed. Immediately after the operation, anti-coagulation therapy was in. He had no particular past history, but his father and brother had suffered from superior mesenteric venous thrombosis. Coagulation study showed lower levels of protein S antigen and activity. This is thought to be a case of superior mesenteric venous thrombosis due to protein S deficiency.