A case of Thrombosis of the Superior Mesenteric Vein due to Protein C and S Deficiency Disease

  • Negishi Hiroyuki
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Kobayashi Shinjiro
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Mori Shuzo
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Tenjin Kazumi
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Nishio Kenji
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Kyoi Reina
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Shimada Jin
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Oshima Ryuichi
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Onoda Keiichiro
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Sakurai Jo
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Koizumi Satoshi
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Asakura Takeshi
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine
  • Otsubo Takehito
    Department of Gastroenterological and General Surgery, St.Marianna University School of Medicine

Bibliographic Information

Other Title
  • プロテインCおよびS欠乏症を認めた上腸間膜静脈血栓症の1例

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Description

The case pertains to a woman in her seventies. She consulted a nearby doctor with the chief complaint of fever and abdominal pain and was diagnosed by careful examination as having thrombosis of the cranial mesenteric vein and referred to our hospital. CT revealed a thrombus in the superior mesenteric vein extending from the ileocolic vein to the section merging with the splenic vein. Moreover, edematous change and parenteral air were observed in the ileocecum, and gastrointestinal perforation at this site was suspected. From the above, the patient was diagnosed as having thrombosis of the superior mesenteric vein and gastrointestinal perforation, and an emergency operation was carried out. Penetration into the mesentery was observed from the ileocecal valve to the ileum on the approximately 3cm oral side. Mild edema was observed almost throughout the length of the ileum;however, the color was normal. Ileocecal resection and colostomy were carried out. Laboratory examination at admission to our hospital revealed decreased serum protein C and S levels. We report this case due to the rarity of thrombosis of the superior mesenteric vein associated with protein C and S deficiency disease.

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