Abstract
Thrombosis of the superior mesenteric vein is a relatively uncommon entity which is sometimes silent and sometimes causes abrupt bowel necrosis. We report two cases of thrombosis of the superior mesenteric vein which was diagnosed by contrast enhanced abdominal CT scan and treated by surgical operation, with the resultant life-saving outcomes. Case 1 and 2 involved a 50-year-old woman and a 28-year-old man, respectively. Both two patients were seen at the hospital because of abdominal pain. Abdominal CT scan showed translucent images in the superior mesenteric and portal veins. Further intestinal edema and ascites were demonstrated, and thus thrombosis of the superior mesenteric vein with intestinal necrosis was diagnosed. The patients underwent lapaotomy. At surgery, the necrosed intestines were removed, and intestinal anastomosis was done through a two-step approach in the case 1 and a one-step approach in the case 2, respectively. After the operation sustained intravenous administration of heparin was conducted for them, and it was switched to oral anticoagulation therapy with walfarin after initiation of oral ingestion. No abnormal findings were recorded in examinations of blood coagulation and fiblinolytic agent, so that idiopathic thrombosis of the superior mesenteric vein was diagnosed in them. These patients did not show any impairment of hepatic function or increase in thrombosis, and their postoperative courses were uneventful. They are followed in the outpatient clinic in our hospital.
