PMID- 7818202
OWN - NLM
STAT- MEDLINE
DCOM- 19950208
LR  - 20190830
IS  - 0750-7658 (Print)
IS  - 0750-7658 (Linking)
VI  - 13
IP  - 2
DP  - 1994
TI  - [Mesentric venous thrombosis. Risk factors, treatment and outcome. An analysis of 
      18 cases].
PG  - 182-94
AB  - Eighteen patients with an acute thrombosis of the splanchnic veins were reviewed. 
      Most of apparently idiopathic cases of splanchnic vein thrombosis are related to 
      an increased coagulation related to a congenital or acquired defect of 
      haemostasis. The aim of this study was to assess the effects of a new and 
      effective treatment. Nine male and 9 female patients (range of age: 19 to 81 
      years) experienced a mesenteric venous thrombosis. There were 14 mesenteric vein 
      thromboses with infarction, two transient mesenteric venous ischaemias without 
      bowel infarction and two acute thromboses of the splanchnic veins without bowel 
      ischaemia. A coagulopathy was detected in seven patients: oral contraception, 
      protein C (PC) or antithrombin III (AT III) congenital deficiencies, acquired 
      deficiency of AT III, PC and protein S (PS), polycythaemia in the post-partum 
      period and primary myeloproliferative disorder. No coagulopathy was associated 
      with thrombosis in eight cases: mesenteric haematoma, splenomegaly, cirrhosis, 
      appendicectomy, cholescytectomy, chronic heart failure, treatment with 
      beta-adrenergic receptor antagonist and digitalis, stenosis of the portal 
      anastomosis after liver transplantation. Twelve patients required surgery: eight 
      intestinal bowel resections with immediate anastomosis, four resections without 
      immediate anastomosis. Only one patient underwent a second look for a repeat 
      bowel resection. No death occurred in the early postoperative period and 17 out 
      of 18 patients were alive after 12 years. An oral anticoagulant therapy was 
      undertaken from two months to seven years. However, three patients suffered a 
      recurrent thrombosis. Two of them required a long-term anticoagulation. Six 
      patients experienced a portal hypertension and oral anticoagulants were 
      discontinued in three of them because of bleeding oesophageal varices. Six 
      patients were treated only by unfractionated heparin (UFH) or low molecular 
      weight heparin (LMWH) followed by oral anticoagulants. After laparotomy, two were 
      only treated with UFH without any bowel resection, as mesenteric venous ischaemia 
      was too extensive. These observations suggest that the choice between an 
      appropriate medical or surgical treatment is important and must be discussed. 
      Since 1989, the therapeutic choice has been modified by ultrasonography and 
      contrast enhanced computed tomographic scan which confirms diagnosis, allows to 
      follow up and check the effects of anticoagulation and to choose the time for 
      surgery. When the diagnosis is established and the patient's risk is low, the IU 
      . kg(-1) . d(-1) to obtain an antifactor Xa activity between 0.3 and 0.6 antiXa 
      IU mL(-1). When the diagnosis is uncertain and the patient's risk if high a 
      laparotomy is required.(ABSTRACT TRUNCATED AT 400 WORDS)
FAU - Lefrancois, C
AU  - Lefrancois C
AD  - Service d'Anesthesie-Reanimation, CHU, Cote-de-Nacre, Caen.
FAU - Derlon, A
AU  - Derlon A
FAU - Le Querrec, A
AU  - Le Querrec A
FAU - Justum, A M
AU  - Justum AM
FAU - Gautier, P
AU  - Gautier P
FAU - Maurel, J
AU  - Maurel J
FAU - Leroux, Y
AU  - Leroux Y
FAU - Lochu, T
AU  - Lochu T
FAU - Sillard, B
AU  - Sillard B
FAU - Deshayes, J P
AU  - Deshayes JP
AU  - et al.
LA  - fre
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Thromboses veineuses mesenteriques. Facteurs de risque, traitement et evolution. 
      Analyse de 18 observations.
PL  - France
TA  - Ann Fr Anesth Reanim
JT  - Annales francaises d'anesthesie et de reanimation
JID - 8213275
RN  - 0 (Anticoagulants)
RN  - 12001-79-5 (Vitamin K)
RN  - 9000-94-6 (Antithrombin III)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/therapeutic use
MH  - Antithrombin III/analysis
MH  - Blood Coagulation Disorders/complications
MH  - Female
MH  - Humans
MH  - Male
MH  - Mesenteric Vascular Occlusion/epidemiology/*etiology/therapy
MH  - Mesenteric Veins
MH  - Middle Aged
MH  - Protein C Deficiency
MH  - Protein S Deficiency
MH  - Risk Factors
MH  - Thrombosis/epidemiology/*etiology/therapy
MH  - Vitamin K/antagonists & inhibitors
RF  - 58
EDAT- 1994/01/01 00:00
MHDA- 1994/01/01 00:01
CRDT- 1994/01/01 00:00
PHST- 1994/01/01 00:00 [pubmed]
PHST- 1994/01/01 00:01 [medline]
PHST- 1994/01/01 00:00 [entrez]
AID - S0750-7658(05)80551-9 [pii]
AID - 10.1016/s0750-7658(05)80551-9 [doi]
PST - ppublish
SO  - Ann Fr Anesth Reanim. 1994;13(2):182-94. doi: 10.1016/s0750-7658(05)80551-9.