Successful Nonsurgical Treatment of Acute Peritonitis Caused by a Large Thrombosis of the Superior Mesenteric Vein in a 25-year-old Woman

Intern Med. 2020 Sep 1;59(17):2143-2147. doi: 10.2169/internalmedicine.4006-19. Epub 2020 May 26.

Abstract

Superior mesenteric venous thrombosis (SMVT), which results from various etiologies, including coagulation disorders, can be diagnosed early using advanced imaging technology. However, few reports have described the nonsurgical treatment of acute peritonitis caused by SMVT. We encountered a young woman whose history included abdominal pain and daily oral contraceptives and who presented with acute peritonitis caused by SMVT. We administered nonsurgical treatment that included thrombolysis and anticoagulation for the peritonitis (without mesenteric ischemia as confirmed by contrast-enhanced computed tomography). In addition, we showed the importance of investigating persistent risk factors for thromboembolism in young patients to determine the duration of anticoagulation.

Keywords: acute peritonitis; anticoagulation; nonsurgical treatment; superior mesenteric venous thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • Contraceptives, Oral / adverse effects
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Mesenteric Veins / diagnostic imaging
  • Mesenteric Veins / physiopathology*
  • Peritonitis / drug therapy*
  • Peritonitis / etiology*
  • Thrombosis / chemically induced*
  • Thrombosis / drug therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anticoagulants
  • Contraceptives, Oral
  • Fibrinolytic Agents