Intestinal ischemia secondary to superior mesenteric venous thrombosis—A case report

Introduction: Acute mesenteric venous thrombosis is a rare but potentially fatal condition with superior mesenteric vein being the most common site of thrombosis development [1]. It is more common in patients with underlying disorders which cause disruptions to Virchow’s Triad of hypercoagulability, stasis and endothelial injury. The disease is often associated with intestinal ischemia in its acute form, further complicating its management. Presentation of case: We present a case of acute superior mesenteric venous thrombosis resulting in jejunal ischemia in a 60-year-old Caucasian male with possible ulcerative colitis. A computed tomography (CT) scan demonstrated features of intestinal infarction. However, the patient was stable after initial resuscitation with a non-peritonitic abdomen and was subsequently managed with conservative measures. Discussion: We have illustrated a case of a patient with acute mesenteric venous thrombosis with potential bowel compromise. Despite concerning CT features, the patient was clinically stable and responded to conservative management. We hope to emphasise that although radiology plays a crucial role in modern medicine, it is important to make therapeutic decisions based on clinical findings. Conclusion: Acute mesenteric venous thrombosis is a complex entity. It requires a multidisciplinary team approach to plan for the most appropriate treatment strategy suitable for each patient as all options are associated with significant risks. The underlying cause should be established as this will determine any long-term management necessary to prevent recurrence.