Abstract
A 56-year-old male patient with complaint of upper abdominal pain was admitted to our hospital with the diagnosis of acute peritonitis. Acute appendicitis was suspected by a CT study of the abdomen and the patient was first treated conservatively. On the 7th day of admission SMV thrombosis was discovered by a CT study and continuous intravenous heparin infusion was started. On the 12th day of admission pain in the right lower quadrant of the abdomen increased and on the 13th day a laparotomy was performed with ileocecal resection. Pathological diagnosis was gangrenous appendicitis. The postoperative course was uneventful and oral warfarin treatment was continued. On the 136th postoperative day SMV thrombosis was found to have disappeared by a CT study. SMV thrombosis is relatively rare disease and its diagnosis is sometimes delayed because of lack of specific symptoms. In case complicated with appendicitis, the thrombosis could progress as inflammation worsens and could cause bowel necrosis. It is important, therefore, to make its early diagnosis and start appropriate control of inflammation. Our case presented here did not cause bowel necrosis, but the inflammation progressed under conservative management. In such a case, an aggressive surgical treatment for the original disease should be undertaken without delay.
