Abstract
A 33-year-old man had been diagnosed with congenital antithrombin (AT)-III deficiency as a grade-schooler. He was admitted to another hospital for pulmonary embolism and deep vein thrombosis in January 2009. Anticoagulant therapy with warfarin was discontinued in August 2009 because of poor compliance. In November 2009, he was admitted to our hospital because of abdominal pain. Enhanced computed tomography (CT) showed segmental infarction of the ileum as welll as thrombosis of the superior mesenteric, portal and splenic veins. AT-III activity was low at 46% of normal. An emergency laparotomy was performed, and segmental intestinal infarction was detected. We resected the necrotic intestine and constructed an ileostomy. He was administered anticoagulant therapy comprised of AT-III, heparin and warfarin. The ileostomy was closed 3 months after the operation. No venous thrombosis was observed during the post-operative course of anticoagulant therapy with warfarin. In cases of acute superior mesenteric vein thrombosis associated with congenital AT-III deficiency, early surgical treatment and anticoagulant therapy are the most important treatments.
