A Case of Ileus with Congenital Antithrombin III Deficiency after Surgery for Mesenteric Venous Thrombosis

Yoshiyuki Ishii, Masahiko Watanabe, Seiichirou Yamamoto, Youhei Chiba, Masami Ishihara, Shin Narai, Tatsuo Teramoto, Masaki Kitajima

Department of Surgery, Keio University School of Medicine

We report a case of ileus due to extended venous thrombosis in a patient with congenital antithrombin III deficiency who was treated by open surgery and medication. On January 2, 1995, a 38-year-old man was diagnosed at another hospital as having an acute abdomen. A partial resection of the jejunum was performed because of necrosis of the small intestine due to idiopathic mesenteric venous thrombosis. After his discharge, the patient was readmitted to a closer hospital with the complaint of vomiting and was diagnosed as having ileus. He was transferred to our hospital on March 20, 1995, after conservative therapy for ileus was ineffective and a thrombus of the portal vein was detected. Through our examinations, congenital antithrombin III deficiency was diagnosed and a mechanical stenosis of the small intestine was detected. Surgical treatment for ileus was performed on May 10, 1995. Venous thrombosis was not induced during this postoperative course. This case of congenital antithrombin III deficiency is significant in that venous thrombosis was not induced during the postoperative course, despite the administration of antithrombin III, heparin and warfarin.

Key words
congenital antithrombin III deficiency, venous thrombosis, ileus

Reprint requests
Yoshiyuki Ishii Department of Surgery, Keio University School of Medicine
35, Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
September 9, 1997

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