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- Laure Elkrief, Olivier Corcos, Onorina Bruno, Beatrice Larroque, Pierre-Emmanuel Rautou, Kamal Zekrini, Frédéric Bretagnol, Francisca Joly, Claire Francoz, Vanessa Bondjemah, Dominique Cazals-Hatem, Larbi Boudaoud, Emmanuelle De Raucourt, Yves Panis, Odile Goria, Sophie Hillaire, Dominique Valla, and Aurélie Plessier.
- Service d'Hépatologie, Hôpital Beaujon and INSERM U773, Clichy, France.
- Liver Int. 2014 Oct 1; 34 (9): 1314-21.
Background & AimsThe most serious complication of acute mesenteric vein thrombosis (MVT) is acute intestinal ischaemia requiring intestinal resection or causing death. Risk factors for this complication are unknown. To identify risk factors for severe intestinal ischaemia leading to intestinal resection in patients with acute MVT.MethodsWe retrospectively analysed consecutive patients seen between 2002 and 2012 with acute MVT in 2 specialized units. Patients with cirrhosis were excluded. We compared patients who required intestinal resection to patients who did not.ResultsAmong 57 patients, a local risk factor was identified in 14 (24%) patients, oral contraceptive use in 16 (29%), and at least one or more other systemic prothrombotic condition in 25 (44%). Five (9%) patients had diabetes mellitus (DM), 33 (58%) had overweight or obesity, 9 (18%) had hypertriglyceridemia and 10 (19%) had arterial hypertension. Eleven patients (19%) underwent intestinal resection. DM was significantly associated with intestinal resection (P = 0.02) while local factors or prothrombotic conditions were not. Computed tomography (CT) scans performed at diagnosis found that occlusion of second order radicles of the superior mesenteric vein was more frequently observed in patients who underwent intestinal resection (P = 0.009).ConclusionsIn acute MVT, patients with underlying DM have an increased risk of requiring intestinal resection. Neither local factors nor systemic prothrombotic conditions are associated with intestinal resection. When CT scan shows the preservation of second order radicles of the superior mesenteric vein, the risk of severe resection is low.© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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