Report of a Young Female With Severe Abdominal Pain: Mesenteric Venous Thrombosis
Mesenteric ischemia is a rare disease with a high rate of mortality because of the non-specific symptoms which leads to delay in diagnosis and intervention. The main symptom is abdominal pain; which has a broad list of differential diagnosis. This study introduces a 17 years old girl who presents to the emergency department with severe abdominal pain and hematemesis. Further evaluations revealed thrombosis in the mesenteric vein which leads to ischemia and gangrene of the small intestine. Her past medical history and drug history was negative, except she was taking Levonorgestrel and cyproterone acetate for a 5 months period. Since long-term treatment with oral contraceptive pills, counts as a risk factor for venous thrombosis, this case seems to be uncommon.
2- Abdu RA, Zakhour BJ, Dallis DJ. Mesenteric venous thrombosis: 1911 to 1984. Surgery. 1987;101:383-388.
3- Rhee RY, Gloviczki P, Mendonca CT, et al. Mesenteric venous thrombosis: still a lethal disease in the 1990s. J Vasc Surg. 1994;20:688-697.
4- Amitrano L, Brancaccio V, Guardascione MA, Margaglione M, Iannaccone L, Dandrea G, Ames PR, Marmo R, Mosca S, Balzano A. High prevalence of thrombophilic genotypes in patients with acute mesenteric vein thrombosis. Am J Gastroenterol. 2001 ;96:146–149.
5- Bergan JJ, Yao JST. Chronic intestinal ischemia.. In: Rutherford RB, ed. Vascular Surgery. 3rd ed Philadelphia, Pa: WB Saunders Co; 1989:825-842.
6- Bingol H, Zeybek N, Cingöz F, Yilmaz AT, Tatar H, Sen D. Surgical therapy for acute superior mesenteric artery embolism. Am J Surg. 2004;188:68–70.
7- Schoots IG, Levi MM, Reekers JA, Lameris JS, van Gulik TM. Thrombolytic therapy for acute superior mesenteric artery occlusion. J Vasc Interv Radiol. 2005;16:317–329
8_ Stoney RJ, Cunningham CG. Acute mesenteric ischemia. Surgery. 1993;114:489-490
9- Kaleya RN, Boley SJ. Acute mesenteric ischemia: an aggressive diagnostic and therapeutic approach: 1991 Roussel Lecture. Can J Surg. 1992; 35:613-623.
10- Mansour MA. Management of acute mesenteric ischemia. Arch Surg. 1999;134:328-330.
11-Kozuch PL, Brandt LJ. Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy. Aliment Pharmacol Ther. 2005;21:201–215.
12- Stewart H, Flannery MT, Humphrey DA. Superior Mesenteric Vein Thrombosis Secondary to Oral Contraceptive Use. Case Reports in Vascular Medicine. Volume 2012 (2012), Article ID 969130.
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