Abstract
We have experienced a patient with superior mesenteric vein thrombosis, who had been followed for liver cirrhosis. This patient was admitted to the hospital because of vague abdominal pain lasting for three days. His abdominal pain gradually worsened, and peritoneal sign appeared on the second hospital day. A abdominal CT scan showed a portal vein thrombus and massive edema of the mesenterium. Under a diagnosis of superior mesenteric thrombosis, an emergency laparotomy was performed and only a completely necrotic segment of the small bowel (200cm) was resected without anastomosis. At the second look operation which was performed in two days, an additional resection of the bowel, 20cm in length with poor viability, was performed with end-to-end anastmosis. With anticoagulation therapy, there have been no signs of recurrence as of 22 months after the operation. Because this patient also had esophageal varices, the portal hypertention is considered to cause the superior mesenteric vein thrombosis. It should be emphasized that in spite of less coagulability in the patients with liver cirrhosis, portal hypertensive state can be a trigger of the superior mesenteric vein thrombosis.
