Step-up strategy for diagnosis and treatment of acute ;superior mesenteric venous thrombosis

VernacularTitle:急性肠系膜上静脉血栓的进阶式诊治
Author: Shuofei YANG ¹ ; Xingjiang WU ; Jieshou LI
Author Information

1. 210008,南京军区南京总医院普通外科研究所
Keywords: Acute superior mesenteric venous thrombosis; Step-up modality of diagnosis and treatment; Damage control surgery; Interventional therapy
From: Chinese Journal of Gastrointestinal Surgery 2014;(5):516-520
CountryChina
Language:Chinese
Abstract: Acute superior mesenteric venous thrombosis is rare. With advance in CT venography, angiography and diagnostic laparoscopy, the incidence of acute superior mesenteric venous thrombosis has increased worldwide with more access to early diagnosis. The use of anticoagulatory medication, interventional radiology, and damage control approach has resulted in better clinical outcomes. At present, the new step-up approach for acute superior mesenteric venous thrombosis includes CT venography as the main diagnostic technique, anticoagulation as the cornerstone of therapy, local transcatheter thrombolytic therapy as the key recanalization method, and adjunctive use of arterial spasmolysis and various endovascular manipulation and damage control surgery by intestinal resection plus jejunostomy and ileostomy or open abdomen. This strategy may further improve clinical outcomes. This review will present the most recent advance in this strategy.