A Case of Superior Mesenteric Venous Thrombosis Caused by Protein C Deficiency.

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  • KOBA Yuji
    Trauma and Critical Care Center, Kameda General Hospital
  • KASAI Takeshi
    Trauma and Critical Care Center, Kameda General Hospital
  • SEKI Kaoruko
    Trauma and Critical Care Center, Kameda General Hospital
  • OYAMA Hisaya
    Trauma and Critical Care Center, Kameda General Hospital
  • INABA Akira
    Trauma and Critical Care Center, Kameda General Hospital

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Other Title
  • プロテインＣ活性低下による上腸間膜静脈血栓症の１例

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Abstract

A 44-year-old man was referred to our hospital because of periumbilical pain. Under a diagnosis of acute peritonitis based on clinical manifestations and CT findings, an emergency laparotomy was undertaken. Operative findings revealed congestive necrosis of the terminal ileum, approximately 20cm in length, due to thrombosis of the superior mesenteric vein. After we removed the thrombus in the superior mesenteric vein by Fogarty's catheter, we infused heparin and urokinase into the portal vein. The ileal lesion was resected approximately 30cm in length and primary anastomosis was undertaken. Heparin, tissue plasminogen activator, and warfarin were administered immediately after surgery. Fortunately, we were able to avoid a second-look operation. The patient had no remarkable past history, but a coagulation study showed lower levels and activity of protein C antigen. We concluded that this case was thrombosis of the superior mesenteric vein resulting from protein C deficiency.

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