A CASE OF SUPERIOR MESENTERIC VEIN THROMBOSIS SECONDARY TO DIVERTICULITIS OF ASCENDING COLON

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  • 上行結腸憩室炎に合併した上腸間膜静脈血栓症の１例

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A 70-year-old man visited a doctor with the main complaints of fever and right abdominal pain. A blood test revealed an inflammation reaction and abdominal enhanced CT showed a thrombus continued to the portal vein from the superior mesenteric vein (SMV), along with ascending colon diverticulitis. He was admitted and diagnosed with superior mesenteric vein thrombosis secondary to diverticulitis of the ascending colon, because blood coagulation and another disease were negative. Because the abdominal symptoms were slight, we preferred conservative therapy and improvement of the inflammation. For thrombosis, we considered anticoagulant therapy immediately, but we canceled because of a hemorrhagic gastric ulcer. Abdominal enhanced CT on day 10 showed improvement of the diverticulitis and the reduction of the thrombus. We confirmed the improvement of the gastric ulcer, and continuous infusion of heparin was performed intravenously from the same day. Heparin was converted to warfarin on day 30, and he was discharged on day 46. But three months later, he was readmitted for recurrence of the diverticulitis. Abdominal enhanced CT on the same day showed a normal SMV.

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