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Licensed Unlicensed Requires Authentication Published by De Gruyter September 10, 2015

Super-mesenteric-vein-expia-thrombosis, the clinical sequelae can be quite atrocious

Superior mesenteric vein thrombosis: an important differential of abdominal pain in a child
  • Benjamin Howell Lole Harris EMAIL logo , Jason Leo Walsh and Sarfraz A. Nazir


Superior mesenteric vein (SMV) thrombosis is a rare, potentially life-threatening complication of intra-abdominal infection. Here we present a case of massive SMV thrombosis secondary to appendicitis in a 13-year-old boy. He presented with vague abdominal pain and associated symptoms, persistently elevated serum inflammatory markers and a pyrexia of unknown origin. Sonography proved inconclusive, and a definitive diagnosis was made by abdominal contrast-enhanced computed tomography. He was treated with antibiotics and anticoagulation before interval elective laparoscopic appendectomy. The non-specific nature of the presenting symptoms makes SMV thrombosis an important differential to consider when dealing with such patients.

  1. Financial disclosure: There are no financial relationships relevant to this article to disclose.

    No external funding was secured for this study.

  2. Conflict of interest: All authors have no conflicts of interest to disclose.

    The first draft was written by Benjamin H.L Harris and Jason L. Walsh jointly.

  3. Contributor’s statements: Benjamin H.L Harris and Jason L. Walsh:

    Drs Harris and Walsh recorded the events of the case, conceptualised and designed the article, drafted the initial manuscript, and approved the final manuscript as submitted.

    Sarfraz A. Nazir:

    Dr Nazir recorded the events of the case and was involved in design of the article. Dr Nazir commented on the various drafts of the manuscript and sourced and interpreted the radiographical images. Dr Nazir critically reviewed the manuscript before final submission.


1. Singh P, Yadav N, Visvalingam V, Indaram A, Bank S. Pylephlebitis – diagnosis and management. Am J Gastroenterol 2001;96:1312–3.Search in Google Scholar

2. Takehara K, Miyano S, Machida M, Kitabatake T, Fujisawa M, et al. Superior mesenteric vein thrombosis as a complication of acute appendicitis: report of a case. Clin J Gastroenterol 2013;6:269–73.10.1007/s12328-013-0390-1Search in Google Scholar

3. Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc 2013;88:285–94.10.1016/j.mayocp.2013.01.012Search in Google Scholar

4. Warren S, Eberhard TP. Mesenteric venous thrombosis. Surg Gynecol Obstet 1935;61:102–21.Search in Google Scholar

5. Harnik IG, Brandt LJ. Mesenteric venous thrombosis. Vasc Med 2010;15:407–18.10.1177/1358863X10379673Search in Google Scholar

6. Rhee RY, Gloviczki P. Mesenteric venous thrombosis. Surg Clin North Am 1997;77:327–38.10.1016/S0039-6109(05)70552-1Search in Google Scholar

7. Virchow R. Gesammelte Abhandlungen zur wissenschaftlichen Medicin. Frankfurt: Von Meidinger & Sohn, 1856.Search in Google Scholar

8. Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr 2000;24:755–60.10.1097/00004728-200009000-00017Search in Google Scholar PubMed

9. Nishimori H, Ezoe E, Ura H, Imaizumi H, Meguro M, et al. Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case. Surg Today 2004;34:173–6.10.1007/s00595-003-2654-8Search in Google Scholar PubMed

10. Bakti N, Hussain A, El-Hasani S. A rare complication of acute appendicitis: superior mesenteric vein thrombosis. Int J Surg Case Rep 2011;2:250–2.10.1016/j.ijscr.2011.08.003Search in Google Scholar PubMed PubMed Central

11. Hassan HA, Raufman JP. Mesenteric venous thrombosis. South Med J 1999;92:558–62.10.1097/00007611-199906000-00002Search in Google Scholar PubMed

12. Kykalos S, Sotiropoulos GC, Vernadakis S. Septic mesenteric venous thrombophlebitis: a rare complication of acute appendicitis. Case Rep Med 2011;2011:858563.10.1155/2011/858563Search in Google Scholar PubMed PubMed Central

13. Fukutomi S, Yasutomi J, Kusashio K, Suzuki M, Fukao K, et al. A case of acute appendicitis complicated with superior mesenteric vein thrombosis. Jpn J Surg Assoc 2008;69:581–5.10.3919/jjsa.69.581Search in Google Scholar

14. Stitzenberg KB, Piehl MD, Monahan PE, Phillips JD. Interval laparoscopic appendectomy for appendicitis complicated by pylephlebitis. J Soc Laparoendosc Surgeons 2006;10:108–13.Search in Google Scholar

15. Plessier A, Darwish-Murad S, Hernandez-Guerra M, Consigny Y, Fabris F, et al, Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study. Hepatology 2010;51:210–8.10.1002/hep.23259Search in Google Scholar PubMed

16. Zhang J, Duan ZQ, Song QB, Luo YW, Xin SJ, et al. Acute mesenteric venous thrombosis: a better outcome achieved through improved imaging techniques and a changed policy of clinical management. Eur J Vasc Endovasc Surg 2004;28:329–34.10.1016/j.ejvs.2004.06.001Search in Google Scholar PubMed

Received: 2015-5-6
Accepted: 2015-7-2
Published Online: 2015-9-10
Published in Print: 2016-11-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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