cqvip:Mesenteric venous thrombosis (MVT) is a rare but potentially catastrophic cli nical complication, which may lead to ischemia or infarction of the intestine an d/or the emergence of portal hypertension. An association between inflammatory b owel disease (IBD) and MVT has previously been described, but clinical factors t hat may contribute to this complication in the setting of IBD are not well chara cterized. Diagnosis of MVT in IBD is difficult, as patients frequently present w ith nonspecific abdominal discomfort, which may delay diagnosis and initiation o f treatment. We report 6 of 545 IBD patients at our center (1.1% ) that develop ed MVT, and describe presentation, diagnostic approaches, treatment options, und erlying contributing factors, and outcome. The diagnosis was determined with abd ominal computed tomography (CT) in 5 of 6 cases. Clinical factors, which were th ought to contribute to MVT, included underlying hypercoagulability, low- flow s tate, uncontrolled inflammation, perioperative time period, and prior surgical m anipulation of the portal vein following orthotopic liver transplantation. There were no deaths as a result of MVT, although 1 patient developed severe portal h ypertension and another experienced intestinal infarction requiring extensive re section. We conclude that MVT is an important clinical consideration in IBD pati ents, specifically during the perioperative setting, and diagnosis is facilitate d with the use of CT scan.
展开▼
