Abdominal pain after uncomplicated laparoscopic appendectomy.

摘要

A19 year-old man reported persistent epigastric discomfort unrelated to food intake, low grade fevers, and general malaise 1 week after laparoscopic appendectomy. A CT scan of abdomen and pelvis revealed superior mesenteric vein (SMV) thrombosis (A, arrows show SMV thrombosis involvement with portal vein; B, arrow shows SMV thrombosis), which was not present on the earlier CT scan that diagnosed his appendicitis (C). He was admitted for intravenous hydration, antibiotics, and anticoagulation. Laboratory results showed a white blood cell count of 23,000 U, with all other findings normal including a hypercoagulable workup. When his symptoms improved, his diet was advanced and warfarin started. He was subsequendy discharged home on warfarin, tolerating a regular diet and having a normal white count. On followup 1 month later, the patient was doing well without complaints. He will remain on warfarin and be reevaluated.