MESENTERIC VENOUS THROMBOSIS TREATED WITH UROKINASE VIA THE SUPERIOR MESENTERIC-ARTERY

A 77-year-old man with a history of multiple surgically treated malign ancies presented with increasing abdominal pain after eating. Computer ized tomographic scan showed superior mesenteric vein and portal vein thrombosis. The patient was treated with selective superior mesenteric artery infusion of urokinase resulting in clinical improvement and ne ar complete resolution of the mesenteric venous thrombosis. An underly ing gastric malignancy was found and is believed to be the cause of th e patient's hypercoagulable state. Direct infusion of urokinase into t he superior mesenteric artery for treatment of mesenteric venous throm bosis is an alternative to surgery in selected patients and an alterna tive to the much more complicated delivery systems presently used.