Primary Mesenteric Venous Thrombosis

Abstract

Three patients with primary mesenteric venous thromboses have been presented. The clinical and pathologic features of these and 34 other patients reported in the literature have been discussed. It is believed that this entity should be considered as distinct from arterial occusions and from more common secondary venous thromboses which develop in the course of a variety of systemic and intra-abdominal disorders. Although the etiology is unknown, we feel that mesenteric venous involvement of the primary type may represent an uncommon manifestation of thrombophlebitic disease more often evident in the lower extremities. The treatment is adequate excision of the involved bowel and its mesentery followed by administration of anticoagulants. This approach has reduced the mortality previously ascribed to mesenteric venous thromboses. The value of prolonged anticoagulant therapy is also discussed.