Mesenteric venous thrombosis

• Causes, incidence, and risk factors

  Mesenteric venous thrombosis is a clot that blocks blood flow in the mesenteric veins, one of two veins through which blood leaves the intestine. The condition interrupts the blood supply to the intestine and can result in damage to the intestines.

  Mesenteric venous thrombosis has a variety of causes. Many of the diseases that lead to this condition cause swelling (inflammation) of the tissues surrounding the veins, including:

  • Appendicitis
  • Cancer
  • Diverticulitis
  • Liver disease with cirrhosis
  • Pancreatitis

  Patients who have blood clotting disorders that make the blood more likely to stick together (clot) have a higher risk for mesenteric venous thrombosis.

• Symptoms
  • Abdominal pain, which may get worse after eating and over time
  • Diarrhea
  • Vomiting
• Signs and tests

  A CT scan is the main test used to diagnose mesenteric venous thrombosis.

  Other tests may include:

  • Angiogram (studying the blood flow to the intestine)
  • MRI
  • Ultrasound of the abdomen and mesenteric veins
• Treatment

  Blood thinners (most commonly heparin) are used to treat mesenteric venous thrombosis. In some cases, medicine can be delivered directly into the clot to dissolve it. This procedure is called thrombolysis.

  Sometimes the clot is removed with a type of surgery called thrombectomy.

  If you have signs and symptoms of peritonitis, you will usually need surgery to remove the intestine. After surgery, you may need an ileostomy (opening from the small intestine into a bag on the skin) or colostomy (an opening from the colon into the skin).

• Expectations (prognosis)

  How well you do depends on the cause of the thrombosis. Getting treatment for the cause before the intestine has died can result in a good recovery.

• Complications

  Intestinal ischemia is a serious complication of mesenteric venous thrombosis. Some or all of the intestine dies because of poor blood supply.

• Calling your health care provider

  Call your health care provider if you have severe or repeated episodes of abdominal pain.

• References

  Ozden N, Gurses B. Mesenteric ischemia in the elderly. Clin Geriatr Med. 2007;23:871-887.

Review Date: 6/10/2008

Reviewed By: Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, Washington; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.