Acute Intestinal Obstruction as an Initial Presentation of Mesenteric Venous Thrombosis

Intestinal ischemia commonly occurs after arterial thrombosis or embolism. Thrombosis of the mesenteric vein accounts for less than 10% of cases of intestinal ischemia. Superior mesenteric vein thrombosis (SMVT) in its chronic form is less culpable to produce intestinal ischemia as it forms sufficient collateral drainage. Intestinal obstruction due to mesenteric venous thrombosis is rare, and so far, only 12 cases have been reported. The majority of them had a distinct episode of acute abdominal pain due to ischemia and later developed bowel stricture and intestinal obstruction. Here we report a case of a 44-year-old male who presented with intestinal obstruction as an initial presentation of SMVT. The patient required surgical resection and anastomosis, and he was started on anticoagulation therapy. This case report reiterates the fact that persistent low-grade mesenteric venous ischemia may lead to bowel stricture formation at a later stage. Therefore, etiological workup and early anticoagulant therapy can be useful to improve recurrence.