A Case of Superior Mesenteric Vein Thrombosis Associated with Left Ventricular Thrombus Formation

Abstract

A 55-year-old man with atopic dermatitis came to emergency department at our hospital due to acute abdominal pain. Abdominal enhanced CT revealed superior mesenteric vein thrombosis，small intestine necrosis and peritonitis. He underwent emergency surgery(jejunectomy). ECG demonstrated abnormal Q waves in I and aVL. The result for hematologic laboratory values on admission revealed no evidence of acute coronary syndrome. After surgery, non-sustained VT was recorded on ECG monitoring. Echocardiography was performed and there was an asynergy in the postero-lateral region of the left ventricular(LV). LV thrombus was also detected. LV ejection fraction was 40%. Left ventricular ejection fraction was 40%. Echocardiography also revealed thrombosis in left ventricular with asynergy of posterior-lateral. Intravenous heparin was begun and the size of LV thrombus was gradually reduced. Thrombosis was gradually reduced. Although acute cerebral infarction, splenic and renal infarction were detected, no apparent organic disorders were found. 11 days after admission, LV thrombus disappeared. We continued the anticoagulant therapy with warfarin, and there was no evidence of the recurrence of thrombus. The case of mesenteric venous thrombosis in this case is thought to be prothrombotic state due to inflammatory conditions. We report a rare case of superior mesenteric vein thrombosis associate with LV asynergy and thrombus formation.