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Vol. 160. Issue 9.
Pages 400-406 (May 2023)
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Vol. 160. Issue 9.
Pages 400-406 (May 2023)
Review
Mesenteric venous thrombosis
Trombosis venosa mesentérica
Pablo Demelo-Rodrígueza,d,
Corresponding author
crhistian.cao@gmail.com

Corresponding author.
, Lucía Ordieres-Ortegaa,b,c, Crhistian-Mario Oblitasa,b,c
a Unidad de Enfermedad Tromboembólica Venosa, Departamento de Medicina Interna. Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Instituto de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, Spain
c Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
d Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain
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Abstract

Mesenteric vein thrombosis (MVT) is a rare condition that can present acutely, subacutely, or chronically. MVT can be isolated or within a splanchnic thrombosis (spleno-porto-mesenteric). Symptomatic cases usually present as nonspecific abdominal pain, with or without signs of intestinal ischemia, and the diagnosis is usually made by imaging test (abdominal CT or MRI) in patients with high clinical suspicion. An early clinical-surgical approach is recommended to screen those patients with warning signs and who benefit from an exploratory laparotomy in addition to anticoagulant treatment, which is the cornerstone of medical treatment. MVT is usually associated with prothrombotic states, with hematological disorders (myeloproliferative syndromes and/or JAK2 gene mutations) being of special clinical relevance. On the other hand, the 5-year survival rate is 70–82% and early overall 30-day mortality from MVT can reach 20–32%.

Keywords:
Mesenteric vein thrombosis
Superior mesenteric vein
Thrombophilia
Intestinal ischemia
Anticoagulation
Resumen

La trombosis venosa mesentérica (TVM) es una entidad poco frecuente, y puede presentarse de manera aguda, subaguda o crónica. Puede ocurrir de forma aislada o en el seno de una trombosis esplácnica (espleno-porto-mesentérica). Los casos sintomáticos suelen presentarse como dolor abdominal inespecífico, con o sin datos de sufrimiento intestinal, y el diagnóstico se realiza habitualmente mediante una prueba de imagen (TC abdominal o RMN) en pacientes con una alta sospecha clínica. Se recomienda un enfoque clínico-quirúrgico precoz para cribar aquellos pacientes con datos de alarma y que se beneficien de una laparotomía exploradora añadida al tratamiento anticoagulante, que es la piedra angular del tratamiento médico. La TVM suele asociar estados protrombóticos, siendo de especial interés clínico los trastornos hematológicos (síndromes mieloproliferativos y mutaciones del gen JAK2). Por otro lado, la tasa de supervivencia a los 5 años es del 70–82%, y la mortalidad global precoz puede llegar hasta el 20–32%.

Palabras clave:
Trombosis de la vena mesentérica
Vena mesentérica superior
Trombofilia
Isquemia intestinal
Anticoagulación

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