1/12. Idiopathic mesenteric thrombosis following caesarean section.Mesenteric venous thrombosis, "the great mimicker", is a very rare disorder in pregnancy and the puerperium, particularly when not associated with any pre-existing thrombophilia or autoimmune states. We describe a patient requiring a resection of 150 cm of gangrenous small bowel after uncomplicated elective Caesarean section. The only risk factor for thrombosis was recovery from an elective Caesarean section, a condition classified by the Royal College of Obstetricians and Gynaecologists as "low risk". death from thromboembolism is the leading cause of maternal mortality and should always be considered with unusual post partum symptoms. early diagnosis of mesenteric vascular occlusion is difficult and recent evidence suggests that elevated GST isoenzyme may be helpful. In all cases of MVT anti-coagulation is the basis of treatment. patients who are not anti-coagulated after surgery have a recurrence rate of 25 per cent compared with 13 per cent of heparinised post-operative patients. As no other pre-existing cause for MVT was found, management was with warfarin for 6 months, the oral contraceptive pill was contraindicated and heparin prophylaxis was recommended for future pregnancies.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
2/12. Acute abdomen during adjuvant chemotherapy: superior mesenteric artery thrombosis associated with CMF chemotherapy.We report a case of superior mesenteric artery thrombosis in a 57-year-old woman undergoing chemotherapy for T1N1M0, breast cancer. Although cancer itself is associated with an increased risk of thrombotic events, treatment with chemotherapy and/or tamoxifen in breast cancer patients increases this risk. Most cases reported are of venous thromboembolism; arterial events are rare.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
3/12. Acute venous thrombosis of spleno-mesenteric portal axis: an unusual localization of thromboembolism in the nephrotic syndrome.The nephrotic syndrome has been frequently associated with thromboembolic episodes. We report the case of a patient affected by minimal change nephropathy who developed acute thrombosis of the spleno-mesenteric portal axis and partially recovered after thrombolytic and anticoagulant therapy. Unfortunately, the patient died of pulmonary embolism after suspension of the anticoagulant therapy for gastrointestinal bleeding.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
4/12. protein c deficiency associated with venous thromboembolism.protein c deficiency has been reported to be associated with a high risk for thromboembolism. We report three patients with protein c deficiency: one suffered from left renal vein thrombosis, another from recurrent venous thrombosis of the legs complicated by pulmonary embolism and the third from an extensive thrombosis of the splanchnic veins with partial budd-chiari syndrome. We discuss the unusual sites of venous thrombosis in protein C deficient patients, the factors which may act as thrombotic trigger and the strategy of long-term prevention.- - - - - - - - - - ranking = 5keywords = thromboembolism (Clic here for more details about this article) |
5/12. Mesenteric venous thrombosis caused by deficiency of physiologic anti-coagulants: report of a case.Mesenteric venous thrombosis is a clinical entity, which is rarely recognized on admission. The patients are admitted with vague abdominal complaints and, eventually, abdominal sepsis might occur requiring laparotomy. Nowadays, underlying hypercoagulable states such as antithrombin-III, protein-C and protein-S deficiencies are recognized more frequently as a distinct cause of mesenteric venous thrombosis. In this paper, a case of mesenteric venous thrombosis due to protein-C deficiency is presented. The patients generally have a history of thromboembolism of the deep veins of the legs at young age. The combination of vague abdominal complaints and a history of thrombosis of the deep veins of the legs should arouse the suspicion of mesenteric venous thrombosis. In these cases, contrast-enhanced computerized tomography is a non-invasive diagnostic means which may provide the diagnosis. If infarction of the gut is present, resection is mandatory and a second-look operation should be performed. After surgery, heparinization is essential. This must be followed by administration of oral anticoagulants for an indefinite period in case of an underlying antithrombin iii, protein-C or protein-S deficiency.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
6/12. Mesenteric vein thrombosis as presenting manifestation of hereditary protein s deficiency.protein s deficiency is inherited as an autosomal dominant trait. Heterozygotes with a reduction of 50% in the plasma protein S concentration are at risk for the development of venous thromboembolism, often occurring at an early age without an apparent cause. In the majority of the patients thrombosis is restricted to the superficial or deep venous system of the legs. In this case report we describe the presence of mesenteric vein thrombosis in a 30-yr-old man with hereditary protein s deficiency. In his family protein s deficiency was also recognized in his mother, brother, and niece. Both his mother and brother had a history of thrombotic disease.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
7/12. Acute anterior myocardial infarction complicated by mural thrombus and peripheral thromboembolism despite anticoagulation.A 43-year-old man had transmural anterior wall myocardial infarction complicated by hypotension and anterior-apical aneurysmal formation. Despite continuous anticoagulation with heparin sodium (heparin) and warfarin sodium (coumadin), a large pedunculated left ventricular thrombus was formed. Four hours after uneventful left ventriculography, the patient experienced acute superior mesenteric embolism. An emergency mesenteric embolectomy and then left ventricular aneurysmectomy with clot evacuation were performed to save the bowel and to prevent further embolization.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
8/12. Local fibrinolysis for superior mesenteric artery thromboembolism.A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activator (rtPA) 40 mg was selectively instilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
9/12. Thoracic aortic thrombosis as a cause of bowel ischemia. A case report.Acute occlusion of the superior mesenteric artery (SMA) is a devastating disease with a high mortality rate. Among its causes is thromboembolism from the heart or from an aortic aneurysm. The authors report a sixty-four-year-old woman who sustained acute occlusion of the SMA from a very large thrombus located on the medial wall of the thoracic aorta, unrelated to an aneurysm. The thrombus was pedunculated and occupied over two thirds of the aortic lumen. Transesophageal echocardiography (TEE) proved to be a valuable tool in diagnosis. The appearance of the thrombus on computed tomographic scan very closely resembled a type B aortic dissection and may have been interpreted as such if the TEE result had not been available.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
10/12. Thrombolysis of a partially occluding superior mesenteric artery thromboembolus by infusion of streptokinase.Occlusion of the superior mesenteric artery by thromboembolism is an uncommon cause of acute intestinal ischemia but carries a high mortality. This report describes a case of mesenteric thromboembolism in an 80-year-old woman treated successfully by selective low-dose infusion of streptokinase over 17 hours. Only twelve previous cases have been reported in the world literature. Selective thrombolytic therapy appears effective in the treatment of mesenteric thromboembolism, particularly in elderly patients with a high operative risk.- - - - - - - - - - ranking = 3keywords = thromboembolism (Clic here for more details about this article) |
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