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Akut superior mezenterik ven trombozuna bağlı mezenterik iskeminin bilgisayarlı tomografi bulguları: Olgu sunumu

Year 2019, Volume: 3 Issue: 3, 262 - 264, 15.03.2019

Emrah Doğan Marwa Mouline Doğan Süha Gül Bünyamin Güney

https://doi.org/10.28982/josam.470446

Abstract

Akut mezenterik iskemi (AMI), mezenterik damarların tıkanması, vazospazm veya hipoperfüzyonun kan akışında azalmaya neden olduğu bir durumdur. Tüm AMI'nin yaklaşık% 5-15'i mezenterik venöz tromboz (MVT) ile ilgilidir. MVT, ileri medikal teknolojilere rağmen yüksek ölüm oranına sahiptir. Bu nedenle, hastalığın prognozunda erken tanı önemlidir. Kontrastlı bilgisayarlı tomografi (BT) ve BT anjiyografi erken tanı için en yararlı radyolojik incelemelerdir. Radyolojik görüntüleri olan 55 yaşındaki hastayı sunduk. Hastamız bir hafta boyunca mevcut olan şiddetli karın ağrısı ile hastaneye başvurdu. MVT'yi distal portal kavşağına kadar superior mezenterik ven boyunca izledik. Hasta bir ay önce başka bir hastanede peptik ülsere bağlı olarak üst gastrointestinal sistem kanama öyküsüne sahipti. Nekroz nedeniyle pnömatozis intestinalis vardı, ileal duvarlar konsantrik kalın ve ödem nedeniyle düşüktü. Segmental ileus bu olaya engel olmaksızın eşlik ediyordu. Radyolojik olarak, MVT'nin neden olduğu AMI olarak değerlendirdik.

Keywords

Mezenterik iskemi Venöz infarkt Mezenterik venöz tromboz

References

  • 1. Herbert GS, Steele SR. Acute and chronic mesenteric ischemia. Surg Clin North Am. 2007;87:1115-34.
  • 2. Brunaud L, Antunes L, Adler SC, Marchal F, Ayav A, Bresler L, et al. Acute mesenteric venous thrombosis: Case for nonoperative management. J Vas Surg. 2001;34:673-9.
  • 3. Al Salamah S, Mirza SM. Acute Mesenteric Venous Thrombosis: Management Controversies. 2004;11:242-7.
  • 4. Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am. 1997;77:327-39.
  • 5. Adaba F, Askari A, Dastur J, et al. Mortality after acute primary mesenteric infarction: a systematic review and meta-analysis of observational studies. Colorectal Dis. 2015;17(7):566-77.
  • 6. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017 Aug 7;12:38.
  • 7. Chang RW, Chang JB, Longo WE. Update in management of mesenteric ischemia. World J Gastroenterol. 2006;12:3243-7.
  • 8. Williams LF. Mesenteric ischemia. Surg Clin North Am. 1988;68:331-53.
  • 9. Witte CL, Brewer ML, Witte MH, Pond GB. Protean manifestations of Pyelothrombosis. Ann Surg. 1985;202:191-202.
  • 10. Furukawa A, Kanasaki S, Kono N, Wakamiya M, Tanaka T, Takahashi M, Murata K. CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol. 2009 Feb;192(2):408-16.
  • 11. Hmoud B, Ashwani K, Kamathz PS. Mesenteric Venous Thrombosis. Journal of Clinical and Experimental Hepatology. 2014;4(3):257–63.

Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report

Year 2019, Volume: 3 Issue: 3, 262 - 264, 15.03.2019

Emrah Doğan Marwa Mouline Doğan Süha Gül Bünyamin Güney

https://doi.org/10.28982/josam.470446

Abstract

Acute mesenteric ischemia (AMI) is a condition caused by a decrease in blood flow due to occlusion of the mesenteric vessels, vasospasm or hypoperfusion. Approximately 5-15% of all AMI are related to mesenteric venous thrombosis (MVT). MVT has high mortality rate despite of advanced medical technologies. Thus, early diagnosis is crucial in the prognosis of the disease. Contrast-enhanced computed tomography (CT) and CT angiography are the most helpful radiological examinations for early diagnosis. We present the case of 55 years old patient with AMI accompanied by radiological images. Our patient was admitted to hospital with severe abdominal pain persistent since a week. The patient had upper gastro-intestinal system (GIS) bleeding history due to peptic ulcer a month ago. In the CT imaging, we found thrombosis along superior mesenteric vein up to distal portal junction. There was pneumatosis intestinalis as a consequence of necrosis, ileal walls were concentric, thick and hypodense because of edema. Total intestinal segments were dilated with air-fluid levels. Ileus was present without obstruction. The findings support the diagnosis of AMI due to MVT.

Keywords

Mesenteric ischemia Venous infarct Mesenteric venous thrombosis

References

  • 1. Herbert GS, Steele SR. Acute and chronic mesenteric ischemia. Surg Clin North Am. 2007;87:1115-34.
  • 2. Brunaud L, Antunes L, Adler SC, Marchal F, Ayav A, Bresler L, et al. Acute mesenteric venous thrombosis: Case for nonoperative management. J Vas Surg. 2001;34:673-9.
  • 3. Al Salamah S, Mirza SM. Acute Mesenteric Venous Thrombosis: Management Controversies. 2004;11:242-7.
  • 4. Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am. 1997;77:327-39.
  • 5. Adaba F, Askari A, Dastur J, et al. Mortality after acute primary mesenteric infarction: a systematic review and meta-analysis of observational studies. Colorectal Dis. 2015;17(7):566-77.
  • 6. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017 Aug 7;12:38.
  • 7. Chang RW, Chang JB, Longo WE. Update in management of mesenteric ischemia. World J Gastroenterol. 2006;12:3243-7.
  • 8. Williams LF. Mesenteric ischemia. Surg Clin North Am. 1988;68:331-53.
  • 9. Witte CL, Brewer ML, Witte MH, Pond GB. Protean manifestations of Pyelothrombosis. Ann Surg. 1985;202:191-202.
  • 10. Furukawa A, Kanasaki S, Kono N, Wakamiya M, Tanaka T, Takahashi M, Murata K. CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol. 2009 Feb;192(2):408-16.
  • 11. Hmoud B, Ashwani K, Kamathz PS. Mesenteric Venous Thrombosis. Journal of Clinical and Experimental Hepatology. 2014;4(3):257–63.
There are 11 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case report
Authors

Emrah Doğan 0000-0002-9446-2294

Marwa Mouline Doğan 0000-0002-3401-895X

Süha Gül This is me 0000-0001-5625-5385

Bünyamin Güney

Publication Date March 15, 2019
Published in Issue Year 2019 Volume: 3 Issue: 3

Cite

APA Doğan, E., Mouline Doğan, M., Gül, S., Güney, B. (2019). Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report. Journal of Surgery and Medicine, 3(3), 262-264. https://doi.org/10.28982/josam.470446
AMA Doğan E, Mouline Doğan M, Gül S, Güney B. Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report. J Surg Med. March 2019;3(3):262-264. doi:10.28982/josam.470446
Chicago Doğan, Emrah, Marwa Mouline Doğan, Süha Gül, and Bünyamin Güney. “Computed Tomography Findings of Mesenteric Ischemia Related to Acute Superior Mesenteric Vein Thrombosis: A Case Report”. Journal of Surgery and Medicine 3, no. 3 (March 2019): 262-64. https://doi.org/10.28982/josam.470446.
EndNote Doğan E, Mouline Doğan M, Gül S, Güney B (March 1, 2019) Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report. Journal of Surgery and Medicine 3 3 262–264.
IEEE E. Doğan, M. Mouline Doğan, S. Gül, and B. Güney, “Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report”, J Surg Med, vol. 3, no. 3, pp. 262–264, 2019, doi: 10.28982/josam.470446.
ISNAD Doğan, Emrah et al. “Computed Tomography Findings of Mesenteric Ischemia Related to Acute Superior Mesenteric Vein Thrombosis: A Case Report”. Journal of Surgery and Medicine 3/3 (March 2019), 262-264. https://doi.org/10.28982/josam.470446.
JAMA Doğan E, Mouline Doğan M, Gül S, Güney B. Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report. J Surg Med. 2019;3:262–264.
MLA Doğan, Emrah et al. “Computed Tomography Findings of Mesenteric Ischemia Related to Acute Superior Mesenteric Vein Thrombosis: A Case Report”. Journal of Surgery and Medicine, vol. 3, no. 3, 2019, pp. 262-4, doi:10.28982/josam.470446.
Vancouver Doğan E, Mouline Doğan M, Gül S, Güney B. Computed tomography findings of mesenteric ischemia related to acute superior mesenteric vein thrombosis: A case report. J Surg Med. 2019;3(3):262-4.
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