Mesenteric venous thrombosis: early diagnosis with abdominal CT scan and interest of screening for thrombophilia

Purpose. - Mesenteric venous thrombosis is an uncommon entity whose diagnos is is difficult because the symptoms are nonspecific. Yet early recognition of this disease helps avoid the evolution towards mesenteric infarction. Methods. - We describe clinical symptoms and hypercoagulable states discove red in six patients with superior mesenteric venous thrombosis. Results. - Five of six patients were admitted to hospital for abdominal pai n whose mean duration was 9 days before the diagnosis of venous thrombosis was made. Three of them had a fever. Two patients had a past history of dee p venous thrombosis. All patients had a hypercoagulable state and three of them had two associated disorders of coagulation. In all cases, abdominal C T scan had permitted the diagnosis of mesenteric venous thrombosis. An anti coagulant therapy was conducted successfully in five of six patients. Conclusion. - A CT abdominal scan done early in the case of nonspecific abd ominal pain, since the patients had a previous history of venous thrombosis , may permit a nonsurgical treatment of mesenteric venous thrombosis. A scr eening for thrombophilia must always be carried out since coagulation disor ders are very frequently the recognised causes in mesenteric venous thrombo sis. (C) 2001 Editions scientifiques et medicales Elsevier SAS.