Mesenteric Thrombosis

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Mesenteric thrombosis is usually a dramatic episode. Recently, a case of mesenteric thrombosis was seen in which the course was not sudden and spectacular but slow and progressive. Because of the unusual duration of the disease and the diagnostic problems encountered a report of this case seemed justified.

The pathema of mesenteric thrombosis is an involvement of the superior or inferior mesenteric vessels either by embolism or by thrombosis. Over 70 per cent of the cases are venous in origin, and the superior mesenteric vessels are more frequently involved than the inferior vessels.1 The following conditions have been described as causes of mesenteric thrombosis: valvular heart lesions, arteriosclerosis and atherosclerosis, aneurysm of the abdominal aorta or superior mesenteric vessels, blood dyscrasias (polycythemia vera and leukemia), abdominal tumors, trauma (blows, great exertion, straining, parturition), septic foci (diverticulitis, ulcerative colitis, and pelvic infections), predisposing factors (surgery of the stomach, appendix, hernia, and pelvis), and finally a small group in which no primary cause can be demonstrated.

Although the incidence of mesenteric thrombosis is greatest between the third and sixth decades, persons of any age may be affected. Cases have been reported in patients as young as 5 and over 80 years of age. Women are more commonly affected than men.

The clinical picture depends upon the stage at which the patient is seen, extent of infarction, and duration of the process. Usually there is an acute condition of the abdomen, but infrequently the onset may be slow as in the reported case. . .



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