Surgery>>>>>Venous and Lymphatic Disease
Question 16#

Mesenteric vein thrombosis (MVT) is associated with all of the following EXCEPT:

a. MVT is less common in patients with hypercoagulable states, malignancy, or cirrhosis
b. 5 to 15% of cases of acute mesenteric ischemia occur as a result of MVT
c. Patients with MVT are treated with fluid resuscitation, heparin anticoagulation, and bowel rest
d. Computed tomography ( CT) scan and magnetic resonance imaging (MRI) are 100% sensitive and 98% specific for MVT

Correct Answer is A

Comment:

Five to 15% of cases of acute mesenteric ischemia occur as a result of mesenteric vein thrombosis (MVT). Mortality rates in patients with MVT may approach 50%. The usual presenting symptom is nonspecific abdominal pain and distention, often accompanied by nausea, vomiting, and diarrhea. Peritoneal signs, suggesting intestinal infarction, are present in fewer than half of MVT patients. MVT is more common in patients with a hypercoagulable states, malignancy, and cirrhosis. MVT occurs as a rare complication of laparoscopic surgery.

Most cases of MVT are diagnosed with contrast-enhanced computed tomography ( CT) scanning or magnetic resonance imaging (MRI) in the course of an evaluation for abdominal pain. The sensitivity and specificity for CT and MRI approach 100% and 98%, respectively. Ultrasound can also be used and has reported sensitivity and specificity of 93% and 99%, respectively.

Patients with MVT are treated with fluid resuscitation, heparin anticoagulation, and bowel rest.