Abstract
A five years old boy was admitted to the Children's Medical Center of Osaka City with abdominal pain lasting for a weak. He had been affected by thrombosis of the superior sagital sinus 10 months prior to this admission. He was explored on an emergency base soon after admission. Operative findings disclosed a presence of superior mesenteric venous thrombosis with no specific cause. The infarcted jejunum was removed and an end to end anastomosis was performed. Inspite of a postoperative anticoagulant therapy, a reccurence of venous thrombosis distal to the initial anastomosis required the second operation 5 days after. Anticoagulant therapy had to be discontinued, because of multiple reccurrences of intra abdominal hematoma which required re-explorations. As the causes of mesenteric venous thrombosis, hypercoagulability due to oral contraceptives, platelet hyperfunction, low Antithrombin III, low fibrinolytic activity in vein itself, have been proposed in the recent reports. In our case, an elevated antifibrinolytic factors (α_2-Macroglobulin and α_1-Antitripsin) were determined as significance, which was considered as one of the potential causative factors of mesenteric venous thrombosis. Since determination of coagulative and fibrinolytic factors has been difficult, these were hardly considered as the cause of mesenteric venous thrombosis. Recent improvement of labo ratory techniques enabled us to detect these abnormalities. Our experience suggested that an elevated antifibrinolytic factors may be a cause of mesenteric venous thrombosis.
