An 83-year-old man had gradually worsening abdominal pain and vomiting. Lap
arotomy revealed segmental intestinal infarction resulting from thrombosis
in the superior mesenteric vein. Necrosed intestine was resected and anasto
mosis was performed successfully. The patient was anticoagulated with intra
venous heparin and nafamostat mesilate followed by oral aspirin. He recover
ed rapidly. Blood chemistry revealed protein C deficiency, while protein S
and antithrombin III levels were normal. Laboratory evaluation of these pro
teins may help define the cause of mesenteric venous thrombosis.