Abstract
A 43-year-old woman was admitted with sudden onset of severe abdominal pain ; thrombosis of the superior mesenteric vein was diagnosed ; a wide area of intestinal necrosis was noted on contrast enhanced CT scan. The patient underwent an emergency laparotomy and a wide area of necrosis of the small intestine due to SMVT was found. The necrotic intestine was resected without anastomosis due to the risk of progression of the necrosis in the remnant intestine ; thrombectomy of the SMV and PV was perfomed. After the first operation, anticoagulant therapy was started. A second operation was done 60 days after the first operation ; no necrosis was found in the intestine and the stumps of the small intestine were anastomosed. However, the patient developed short bowel syndrome since the residual intestine was about 10 cm long. The patient could take food by mouth, but her nutritional status deteriorated following the reduction of parenteral nutrition therapy.
Thus, she was placed on a cyclical program of total parenteral nutrition. This enabled her to resume her normal social activities.
