Superior mesenteric and portal vein thrombosis caused by congenital antithrombin III deficiency: Report of a case
Superior mesenteric and portal vein thrombosis caused by congenital antithrombin III deficiency: Report of a case
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DOI：
10.1007/s00595-006-3382-7
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发表时间：
2007-04-01
期刊：
影响因子：
2.5
通讯作者：
Kohno, Hitoshi
中科院分区：
文献类型：
--
作者：
Shibahara, Kotaro;Tatsuta, Kyosuke;Kohno, Hitoshi
一名 50 岁男性，有 24 小时腹痛逐渐加重的病史。增强计算机断层扫描显示小肠节段性扩张、肠壁增厚和腹水，以及肠系膜上静脉 (SMV) 和门静脉血栓形成。因此，进行了紧急剖腹手术，结果显示 SMV 和门静脉血栓形成导致节段性肠梗塞。我们切除了坏死的肠道并进行了吻合术。患者接受静脉肝素和甲磺酸萘莫司他抗凝治疗。术后4天，腹痛再次出现，需要进行第二次剖腹手术。发现肠道节段性充血，又做了一次切除手术，之后很快康复了。随后，血液化学检查显示他患有抗凝血酶 III 缺乏症，在对他的家人进行筛查后，证实这是先天性的。因此，对这些蛋白质的实验室检测可能有助于确定肠系膜静脉血栓形成的原因。
A 50-year-old man presented with a 24-h history of gradually worsening abdominal pain. Enhanced computed tomography showed segmental dilation of the small intestine, wall thickening, and ascites, as well as thrombosis of the superior mesenteric vein (SMV) and portal vein. Thus, an emergency laparotomy was performed, which revealed segmental intestinal infarction caused by the thrombosis in the SMV and portal vein. We resected the necrosed intestine and performed anastomosis. The patient was given intravenous heparin and nafamostat mesilate as anticoagulation therapy. The abdominal pain again recurred 4 days after this operation, necessitating a second laparotomy. Segmental congestion of the intestine was found and another resection was done, after which he recovered rapidly. Blood chemistry subsequently revealed an antithrombin III deficiency, which was confirmed to be inherent, after screening his family. Thus, laboratory testing for these proteins may help define the cause of mesenteric venous thrombosis.