Superior mesentric vein thrombosis after colectomy in a patient with Crohn's disease

Andrew S. Ross, Arunas Gasparaitis, Roger Hurst, Stephen B. Hanauer, David T. Rubin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: An 18-year-old woman with a history of Crohn's disease presented in January 2004 with severe epigastric pain, nausea and vomiting of 4 hours' duration. The patient was diagnosed with inflammatory bowel disease, thought to be consistent with ulcerative colitis, in March 2003, but had no medical history up until this point. Initial treatment with mesalamine was unsuccessful and she subsequently presented with medically resistant fulminant colitis and required an urgent colectomy in June 2003. Her immediate postoperative course was uneventful and she was discharged on tapering doses of prednisone. In August 2003, an ileoscopy revealed inflamed, mildly ulcerated mucosa, and biopsies were consistent with Crohn's disease. Azathioprine was added to the treatment regimen and the patient tapered off prednisone. At this stage the patient continued to do well clinically up until presentation. Investigations: Small bowel series, abdominal CT scan, abdominal ultrasound, exploratory laparotomy. Diagnosis: Acute mesenteric ischemia secondary to superior mesenteric vein thrombosis. Management: Resection of necrotic bowel, antibiotics and systemic anticoagulation.

Original languageEnglish (US)
Pages (from-to)281-285
Number of pages5
JournalNature Clinical Practice Gastroenterology and Hepatology
Volume2
Issue number6
DOIs
StatePublished - Jun 2005

Keywords

  • Colectomy
  • Colitis
  • Crohn's disease
  • Superior mesenteric vein
  • Thrombosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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