Learning objectives
- To describe mesenteric venous thrombosis (MVT) as a pathological entity,
as well as the complications associated with it.
- To recognize on computerized tomography (CT) the radiological signs compatible with a MVT.
- To identify by CT the complications derived from MVT,
especially mesenteric ischemia which has a very bad prognosis.
Background
MVT is an uncommon disease,
it represents between 5% and 20% of episodes of mesenteric ischemia,
depending on the literature consulted.
It's potentially lethal,
between 12.5-50% of complicated cases with intestinal infarction die.
MVT presents with nonspecific symptoms and the diagnostic delay worsens the prognosis.
CT is a sensitive,
specific,
rapid,
non-invasive and available imaging technique.
Classification of MVTaccording to the cause:
- Primary: idiopathic,
without risk factors.
- Secondary (most frequent) to:
Intra-abdominal pathology:
Abdominal surgery,
closed abdominal trauma.
Inflammatory/infectious diseases: pancreatitis,
inflammatory bowel...
Findings and procedure details
Below we present the diagnosed cases of MVT in our center in the last five years and describe the findings detected bycontrast-enhanced MDCT of the abdomen:
Conclusion
- TVM is a rare entity that we should suspect with a correct clinical orientation.
- CT can detect the direct and indirect signs of TVM and its possible complications to decide the therapeutic management.
References
- Duran R,
Alban D,
Letovanec I et al.
Multidetector CT Features of Mesenteric Vein Thrombosis.
RadioGraphics 2012;32(5):1503-22
- BradburyMS,
KavanaghPV,
BechtoldRE,
et al.Mesenteric venous thrombosis: diagnosis and noninvasive imaging.
RadioGraphics 2002;22(3):527–41
- Ramos MJ,
Vaquero F et al.
Trombosis venosa mesentérica aguda como causa de isquemia.
Angiología 2005;57(4):319-28
- Hmoud B,
Singaly AK,
Kamathz PS.
Mesenteric Venous Thrombosis.
Journal of Clinical and Experimental Hepatology 2014;4(3):257-63
- Seijo S,
García JC.
Trombosis portal.
Gastroenterología y Hepatología 2010;33(3):179-90
- Vietti Violi N,
Fournier N,
Duran R...