Initial Management of Extensive Mesenteric Venous Thrombosis: Retrospective Study of Nine Cases

Cenedese, Alice; Monneuse, Olivier; Gruner, Laurent; Tissot, Etienne; Mennesson, Nicolas; Barth, Xavier
October 2009
World Journal of Surgery;Oct2009, Vol. 33 Issue 10, p2203
Academic Journal
The development of mesenteric venous thrombosis (MVT) does not necessarily require surgical intervention. The aim of this study was to assess the efficacy of avoiding early operative intervention, which can lead to significant sacrifice of the small bowel. Patients with MVT were identified using the inpatient registry for the years between 2003 and 2007. Each patient’s past medical history, history of prior deep venous thrombosis or hypercoagulable state, clinical and biologic presentation, and computed tomography (CT) results were analyzed. The proportion of ischemic bowel observed on the CT scans was compared with the length of the bowel resected. Nine patients were admitted for extensive MVT during the time period evaluated (six men, three women). All CT scans demonstrated signs of severe bowel ischemia, with a mean ischemic bowel proportion of 21% (range 5–45%). Four patients received medical management alone. Five patients underwent surgery. The mean admission time for these patients prior to the operation was 14.8 days (6–36 days). Surgery was required only in cases of intestinal perforation. The mean length of the bowel resections was 33 cm (20–45 cm). At 6 months after admission, none of the patients required parenteral nutrition. The mean follow-up evaluation period was 27 months (15–38 months). One patient died secondary to amyotrophic lateral sclerosis during the follow-up. Initial nonsurgical management comprised of inpatient observation on a surgical ward along with systemic anticoagulation must be considered an alternative treatment strategy for MVT. This strategy delays surgery and therefore avoids short bowel syndrome.


Related Articles

  • Motor neurone disease: can we do better? A study of 42 patients. Newrick, P.G.; Langton-Hewer, R. // British Medical Journal (Clinical Research Edition);9/1/1984, Vol. 289 Issue 6444, p539 

    Investigates the management of patients with motor neurone disease. Symptoms of the disease; Use of an electric turning bed; Issues of criticism.

  • Beware tunnel vision. Johnson, Jonas T. // Cortlandt Forum;11/25/96, Vol. 9 Issue 11, p51 

    Presents an account of the author's experience of diagnosing a patient with amyotrophic lateral sclerosis. Clinical manifestation; Need for neurologic examinations to confirm the diagnosis; Tunnel vision as a functional disorder.

  • Development of a pathway to facilitate gastrostomy insertion for patients with MND. Oliver, David; Bell, Jenny; Gallagher, Donal; Newton, Jenny; Rackham, Claire; Swannick, Jackie; Thompson, Sheila // International Journal of Palliative Nursing;Sep2007, Vol. 13 Issue 9, p426 

    A pathway has been developed using a multidisciplinary group from within specialist palliative care to ensure a comprehensive approach to the insertion of gastromy tubes for patients with motor neurone disease (MND) with swallowing difficulties. The pathway has ensured that there is a...

  • Helping patient with 'Lou Gehrig's disease' Bartels, Elizabeth J. // RN;Dec79, Vol. 42 Issue 12, p48 

    Discusses how to provide nursing care to patients with amyotrophic lateral sclerosis (ALS). Description of ALS; Needs of an ALS patient; Considerations in teaching an ALS patient about his condition.

  • class project. Brunner, Elyssa Lee, Jeryl // InStyle;Dec2001, Vol. 8 Issue 14, p298 

    Reports on the annual Project ALS charity event in New York City that helps fund research for amyotropic lateral sclerosis. Impression of actress Molly Shannon on the charity; Amount raised; Attendees to the event.

  • The other side of the bed rail. Horn, Mary O'Flaherty // Annals of Internal Medicine;06/01/99, Vol. 130 Issue 11, p940 

    Relates the experiences of a physician with amyotrophic lateral sclerosis on being treated as a patient by an indifferent physician. Importance of treating patients with empathy and compassion; Embarrassment and degradation felt by the physician on being treated as an experimental preparation;...

  • The physician-patient relationship in amyotrophic lateral sclerosis. Pasetti, C; Zanini, G. // Neurological Sciences;Oct2000, Vol. 21 Issue 5, p318 

    The principal models of the physician-patient relationship are analysed in terms of their historical development. An outline is given of the clinical, psychological and ethical particularities of the approach to patients with amyotrophic lateral sclerosis. The peculiarities of this disease are...

  • ALS patients, relatives can apply for scholarship awards.  // West County Journal;6/22/2011, Vol. 47 Issue 25, pB3 

    The article reports that the Robert A. Stehlin Campaign for ALS has started accepting applications for the RASCALS Higher Education Scholarship Program in June 2011.

  • CAVALIER COURAGE. Collins, Stefanie // Beer & Brewer;Autumn2013, Issue 24, p30 

    The article presents the author's insight regarding his brewed beer for Motor Neurone Disease (MND). The author mentions that he was diagnosed with MND with two to three years to live in which he decided to homebrew again to experience some joy and connect with his friend. The author adds that...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics