Mesenteric Venous Thrombosis: a rare cause of bowel obstruction

Abstract

Introduction: Mesenteric vein thrombosis is a rare cause of mesenteric ischaemia, potentially lethal. The clinical presentation is subtle and insidious, what makes diagnosis difficult in the early stage of disease. This condition exceptionally presents with bowel obstruction, which is due to the onset of an ischaemic stenosis, usually at the small intestine.

Case report: The present article reports a case of mesenteric venous thrombosis that presented with signs of sub-occlusion. Protein C deficiency was diagnosed on further investigation. A segmental bowel resection was required for stenosis removal, in addition to anticoagulant therapy, which prevented the recurrence of new thrombotic events.

Conclusions: Mesenteric venous thrombosis is a rare manifestation of protein C deficiency, but potentially life-threatening. The occurrence of mesenteric venous thrombosis should raise the index of suspicion for an underlying thrombophilia, especially if there is a positive personal or family history of other thrombotic events. The timely recognition of these entities allows effective therapeutic measures, which result in decreased morbidity and mortality.

Keywords: bowel obstruction, mesenteric vein thrombosis, Protein-C deficiency