Abstract
It is difficult to diagnose the superior mesenteric venous thrombosis (SMVT) preoperatively due to nonspecific symptoms and slow progress. We report a case of SMVT that was diagnosed using ultrasonography (US) for observation.
A 66-year-old male patient with sudden abdominal pain and distention showed localized edema of the small intestine and mesenteric edema and ascites found by US. We suspected obstruction in mesenteric blood flow, however US did not depict the thrombus in superior mesenteric artery or vein. The absence of peritoneal irritation signs suggested the low possibility of intestinal necrosis, leaving us to monitor the patient by US. Five hours later, US observation showed the enhanced spread of ascites and edema of the small intestine with dilated superior mesenteric veins in mesentery. Emergency laparotomy was performed to remove the hemorrhagic necrotic part of the small intestine from ileum (approximately 130 cm in length) and bloody ascites. Pathological diagnosis revealed the fresh thrombosis in the superior mesenteric vein and transmural hemorrhagic infarction. In conclusion, the US observation appears to be useful for the preoperative diagnosis of SMVT.
