ABSTRACT

This chapter focuses on the acute form of Mesenteric vein thrombosis (MVT). The incidence of MVT in the general population is poorly defined, but seems to be rather uncommon. Patients with acute MVT may note a sudden onset of abdominal pain, which may quickly progress within hours to include signs of peritonitis with bowel infarction. Identification and treatment or elimination of the causal factors for MVT is central to clinical assessment and therapy. The onset of progressive abdominal pain in the patient with disproportionally few physical findings should prompt the clinician to think about MVT as a possible diagnosis. Magnetic resonance imaging also has excellent sensitivity and specificity for the diagnosis of MVT. The lack of residual mesenteric venous flow by Doppler assessment is also quite specific for the diagnosis of MVT. Endovascular therapies may be pursued for selected patients with acute MVT that is diagnosed early in the course of the disease before bowel infarction or peritonitis develops.