Clinical presentation, diagnosis and management of acute mesenteric vasculopathy in a tertiary referral centre
Saraf, S.; Puri, R.; Anand, V.; Sud, R.; Sama, S.K. and Arora, A. (2002) Clinical presentation, diagnosis and management of acute mesenteric vasculopathy in a tertiary referral centre. Indian Journal of Gastroenterology 2002, 21(Suppl 1) November.
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Background: Mesenteric venous and arterial thrombosis are uncommon type of intestinal ischemia, associated with significant morbidity and mortality because of delay in diagnosis. Methods: A retrospective analysis of 19 patients presenting with either mesenteric venous or arterial thrombosis was performed between January 2001 to May 2002. Results: Sixteen out of 19 patients had thrombosis of superior mesenteric vein, the rest had mesenteric arterial thrombosis. The most common presenting symptom was abdominal pain (100%). 16 patients had features of small bowel obstruction (84%).5 patients had lower GI bleed (26% ), and 1 had upper GL bleed. Radiological investigations included abdominal X-ray, ultrasound and computed tomography. Thrombosis was detected on CT scan in 15 patients (79%). An etiological factor could be found in 6 patients (32%). 14 patients had bowel gangrene and underwent resection anastomosis, the rest were managed conservatively. Post operative mortality was 5.2 %. Conclusion: Diagnosis of intestinal ischemia due to mesenteric vasculopathy is often delayed and a strong clinical suspicion with aggressive treatment can substantially decreased the morbidity and mortality.
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