Abstract
A 53-year-old woman was emergently admitted with upper abdominal pain, nausea and fever. Enhanced computed tomography was performed, which showed multiple thrombi in the portal vein, superior mesenteric vein, inferior vena cava, internal iliac vein and left pulmonary artery, as well as edema of the small intestine with ascites, thereby suggesting jejunal necrosis. After insertion of an IVC filter, she underwent on emergency operation in which a 180-cm segment of necrotic jejunum with bloody ascites was resected. The resected necrotic small intestine was not anastomosed. After the operation, she was treated with intravenous urokinase, heparin and AT-III concentrate, because plasma AT-III activity was decreased. After the multiple thromboses diminished, which had increased temporally, the resected jejunum was anastomosed on the 54th post-operative day. In the 8 years since this operation, she has been maintained on warfarin without thrombus reccurence.
