Ultrasound features and clinical characteristics of intestinal ischemia secondary to acute mesenteric venous thrombosis

Abstract

Objective: To examine the ultrasound features and clinical characteristics of the intestinal ischemia secondary to acute mesenteric venous thrombosis (AMVT). Methods: From January 2016 to June 2019, 11 patients were diagnosed as intestinal ischemia secondary to AMVT confirmed by surgical pathology or CT in Peking Union Medical College Hospital. The patients included 7 males and 4 females, aging of (52.8±11.9) years (range: 34 to 81 years).The clinical characters and ultrasound features were retrospectively reviewed. Results: Abdomen pain was the chief complaint of all patients. Other complaints include 2 cases of blood in the stool, 1 case of hematemesis, 2 cases of vomiting, 1 case of diarrhea. Six patients showed rebound pain on physical examination. All patients had elevated white blood cell account and D-Dimer. Nine patients had a thrombosis in the portal vein simultaneously. All 11 patients underwent the CT scan including 10 contrast-enhanced CT. Mesenteric venous thrombosis was detected in 10 cases who underwent contrast-enhanced CT imaging. On CT imaging, 11 patients demonstrated intestinal wall thicken, 5 patients showed intestinal dilation. Eight patients underwent superior mesenteric venous ultrasound examination. Of them, 7 patients were correctly diagnosed as AMVT. Of the 10 patients who underwent abdominal ultrasound, 5 patients showed intestinal lesions including intestinal wall thicken in 4 patients and intestinal dilation in 1 patient. Peritoneal fluid was detected in 10 patients by ultrasound, which was consistent with CT. Ten patients underwent surgical procedures while 1 patient received conservative treatment. Conclusion: Ultrasound is an accurate imaging method in diagnosing superior mesenteric vein thrombosis and can detect intestinal wall thickening, intestinal dilation, and peritoneal fluid.