Mesenteric Thrombosis refers to a clot in the mesenteric vein, which serves all the abdominal organs to carry used blood back to the heart. Without treatment, it can cause part of the bowel to die, with subsequent Peritonitis and fatal Sepsis. The disease is rare, and only occurs if a predisposing condition exists. These include:
- Acute abdominal diseases like pancreatitis, diverticulitis, and more
- Chronic abdominal diseases like cirrhosis, inflammatory bowel disease, and others
- Recent abdominal trauma or surgery
- Hereditary abnormalities in blood clotting
- Other reasons to clot easily like active cancer, Lupus, estrogen use, and more
Symptoms are mainly severe abdominal pain, which may start abruptly, or develop gradually over several days. In early stages, the classic finding on physical exam is surprisingly minimal abdominal tenderness to palpation (pressing on it), in contrast to the moderate-severe pain the patient seems to be experiencing. Diagnosis is made by CT Scan or MRI, using a special technique with timed injection of dye to catch it when it reaches the intestinal veins. We can’t simply order a regular image.
Treatment involves anticoagulant medications (“blood thinners”) to stop the clot from extending, while the body dissolves it on its own. Some patients require surgery.