Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10629
Peer-review started: April 19, 2022
First decision: June 2, 2022
Revised: June 21, 2022
Accepted: September 1, 2022
Article in press: September 1, 2022
Published online: October 16, 2022
Mesenteric ischemia represents an uncommon complication of splanchnic vein thrombosis, and it is less infrequently seen in young women using oral contraceptives. Diagnosis is often delayed in the emergency room; thus, surgical inter
We report a 28-year-old female patient on oral contraceptives who presented with acute abdominal pain. Her physical examination findings were not consistent with her symptoms of severe pain and abdominal distention. These findings and her abnormal blood tests raised suspicion of acute mesenteric ischemia (AMI) induced by splanchnic vein thrombosis. Contrast-enhanced abdominal computed tomography revealed ischemia of the small intestine with portomesenteric and splenic vein thrombosis (PMSVT). We treated the case promptly by anticoagulation after diagnosis. We then performed delayed segmental bowel resection after thrombus regression and established collateral circulation guided by collaboration with a multidisciplinary team. The patient had an uneventful post
AMI induced by PMSVT should be considered in young women who are taking oral contraceptives and have acute abdominal pain. Prompt anticoagulation followed by surgery is an effective treatment strategy.
Core Tip: Mesenteric ischaemia is an uncommon complication of portomesenteric and splenic vein thrombosis (PMSVT) due to oral contraceptive. We report here a case of mesenteric ischaemia secondary to PMSVT, in which contrast-enhanced abdominal computed tomography played a key role in confirming the diagnosis. This report aims to contribute more information concerning the clinical characteristics as well as demonstrate that prompt anticoagulation followed by surgical invention is an effective strategy and importance of collaboration of multi-disciplinary teamwork for management of acute mensenteric ischemia caused by PMSVT.