Successful anticoagulation with hirudin in a patient with mesenteric venous thrombosis and multiple coagulation abnormalities

A case of multiple thrombotic diatheses discovered in the setting of mesent eric venous infarction is discussed. The patient had deficiencies of protei n C, protein S, antithrombin I II; was heterozygous for factor V Leiden; an d had polycythemia vera. Adequate anticoagulation could not be established with heparin administration and hirudin was used. The diagnosis of mesenter ic venous infarction, thrombotic tendency of multiple coagulation diatheses , and use of hirudin are discussed.