BACKGROUND Among the various types and causes of mesenteric ischemia,superior mesenteric vein(SMV)thrombosis is a rare and ambiguous disease.If a patient presents with SMV thrombosis,past medical history should be rev...BACKGROUND Among the various types and causes of mesenteric ischemia,superior mesenteric vein(SMV)thrombosis is a rare and ambiguous disease.If a patient presents with SMV thrombosis,past medical history should be reviewed,and the patient should be screened for underlying disease.SMV thrombosis may also occur due to systemic infection.In this report,we describe a case of SMV thrombosis complicated by influenza B infection.CASE SUMMARY A 64-year-old male visited the hospital with general weakness,muscle aches,fever,and abdominal pain.The patient underwent computed tomography(CT)and was diagnosed with SMV thrombosis.Since the patient’s muscle pain and fever could not be explained by the SMV thrombosis,the clinician performed a test for influenza,which produced a positive result for influenza B.The patient had a thrombus in the SMV only,with no invasion of the portal or splenic veins,and was clinically stable.Anticoagulation treatment was prescribed without surgery or other procedures.The follow-up CT scan showed improvement,and the patient was subsequently discharged with continued oral anticoagulant treatment.CONCLUSION This case provides evidence that influenza may be a possible risk factor for SMV thrombosis.If unexplained abdominal pain is accompanied by an influenza infection,examination of an abdominal CT scan may be necessary to screen for possible SMV thrombosis.展开更多
Enterocolic phlebitis(EP)is a rare cause of bowel ischemia due to isolated venulitis of the bowel wall and mesentery without arterial involvement.EP is often misdiagnosed as inflammatory bowel disease,carcinoma,or dive...Enterocolic phlebitis(EP)is a rare cause of bowel ischemia due to isolated venulitis of the bowel wall and mesentery without arterial involvement.EP is often misdiagnosed as inflammatory bowel disease,carcinoma,or diverticulitis due to non-specific symptoms as well as non-specific clinical and radiologicalfindings.While unresponsive to pharmacotherapy,surgical resection of the affected bowel appears to be the only successful therapy with a very low recurrence rate.Etiology of EP remains unknown.We report a case of EP with rare presentation in the left hemicolon and unusual histologicalfindings emphasizing the heterogeneity of this cause of enterocolic ischemia.The review and comparison of the three enti-ties—EP,mesenteric inflammatory veno-occlusive disease(MIVOD),and idiopathic myointimal hyperplasia of mesenteric veins(IMHMV),all describing patterns of bowel ischemia due to isolated pathology of mesenteric veins—reveal that the current terminology is unclear.EP and MIVOD are very similar and may be considered the same disease.IMHMV,though,differs in localization,symptom duration,and histologicalfindings but also shares features with EP and MIVOD.Further studies and harmonized terminology are inevitable for better understanding of the disease,prevention of unnecessary pharmacotherapy,and reduction in time to diagnosis.展开更多
文摘BACKGROUND Among the various types and causes of mesenteric ischemia,superior mesenteric vein(SMV)thrombosis is a rare and ambiguous disease.If a patient presents with SMV thrombosis,past medical history should be reviewed,and the patient should be screened for underlying disease.SMV thrombosis may also occur due to systemic infection.In this report,we describe a case of SMV thrombosis complicated by influenza B infection.CASE SUMMARY A 64-year-old male visited the hospital with general weakness,muscle aches,fever,and abdominal pain.The patient underwent computed tomography(CT)and was diagnosed with SMV thrombosis.Since the patient’s muscle pain and fever could not be explained by the SMV thrombosis,the clinician performed a test for influenza,which produced a positive result for influenza B.The patient had a thrombus in the SMV only,with no invasion of the portal or splenic veins,and was clinically stable.Anticoagulation treatment was prescribed without surgery or other procedures.The follow-up CT scan showed improvement,and the patient was subsequently discharged with continued oral anticoagulant treatment.CONCLUSION This case provides evidence that influenza may be a possible risk factor for SMV thrombosis.If unexplained abdominal pain is accompanied by an influenza infection,examination of an abdominal CT scan may be necessary to screen for possible SMV thrombosis.
文摘Enterocolic phlebitis(EP)is a rare cause of bowel ischemia due to isolated venulitis of the bowel wall and mesentery without arterial involvement.EP is often misdiagnosed as inflammatory bowel disease,carcinoma,or diverticulitis due to non-specific symptoms as well as non-specific clinical and radiologicalfindings.While unresponsive to pharmacotherapy,surgical resection of the affected bowel appears to be the only successful therapy with a very low recurrence rate.Etiology of EP remains unknown.We report a case of EP with rare presentation in the left hemicolon and unusual histologicalfindings emphasizing the heterogeneity of this cause of enterocolic ischemia.The review and comparison of the three enti-ties—EP,mesenteric inflammatory veno-occlusive disease(MIVOD),and idiopathic myointimal hyperplasia of mesenteric veins(IMHMV),all describing patterns of bowel ischemia due to isolated pathology of mesenteric veins—reveal that the current terminology is unclear.EP and MIVOD are very similar and may be considered the same disease.IMHMV,though,differs in localization,symptom duration,and histologicalfindings but also shares features with EP and MIVOD.Further studies and harmonized terminology are inevitable for better understanding of the disease,prevention of unnecessary pharmacotherapy,and reduction in time to diagnosis.
