上腸間膜静脈血栓症を合併した急性虫垂炎の1例

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  • A case of acute appendicitis complicated by superior mesenteric vein thrombosis
  • ショウレイ ジョウチョウカンマク ジョウミャク ケッセンショウ オ ガッペイ シタ キュウセイ チュウスイエン ノ 1レイ

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A 25-year-old male patient complained of upper abdominal pain and was admitted to hospital. Acute appendicitis complicated by a superior mesenteric vein thrombosis was suspected on CT. The patient required an appendectomy and abdominal abscess drainage. On the first postoperative day, a continuous intravenous heparin infusion was started. The postoperative course was uneventful, and oral warfarin treatment was continued. Six months after surgery, the superior mesenteric vein thrombosis was found to have disappeared on CT. In such thrombosis cases complicated by appendicitis, the thrombosis can progress as the inflammation worsens and can cause bowel necrosis. Therefore, it is important to make an early diagnosis and to start appropriate control of the inflammation. Had bowel necrosis occurred, there was a high likelihood that a massive small intestine resection would have been required. In the present case, an appendectomy conducted immediately to control abdominal inflammation prevented bowel necrosis.

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