Abstract
A 66-year-old man referred for diffuse abdominal pain, nausea and vomiting. Emergency laparotomy underwent under a diagnosis of ileus by based on computed tomography (CT) findings. Operative findings showed intestinal gangrene and a swollen mesenterium. Massive thrombus was found in the mesenteric vein. The affected bowel was resected with end-to-end anastomosis. On postoperative day (POD) 2, he experienced of severe abdominal pain and CT showed edema of the small intestine and ascites. Reoperation showed recurrent thrombosis and the previous surgical procedure was repeated. The remaining small intestine was 65 cm long. Immediately after surgery, we started anticoagulation therapy. The patient recovered well and was discharged on POD 44. Coagulation studies showed no abnormality and we considered this a case of primary thrombosis.
