A Case of Ileus with Duodenum-Transverse Colon Fistula Caused after Conservative Treatment of Superior Mesenteric and Portal Vein Thrombosis

Kenichiro Saito, Kazushige Shibahara, Masaru Kurokawa, Hideki Moriyama and Hiroshi Hasegawa

Department of Surgery, Toyama Red Cross Hospital

A 76-year-old woman admitted for upper abdominal pain, nausea, and vomiting was found in enhanced abdominal computed tomography (CT) to have mesenteric and portal vein thrombosis. Small-intestine necrosis was not suspected. Her syptoms were relieved by continuous transvenous injection of heparin sodium solution. Four months later, she suffered bowel-obstructive ileus following nausea and vomiting. Enterography showed severe stenosis at the upper jejunum and duodenum-transeverse colon fistula. Laparotomy showed severe 4 cm stenosis in the jejunum about 40 cm distal from Treitz's ligament, necessitating partial jejunal resection. The patient was discharged as healthy. Patients should thus be followed up even in the late phase of superior mesenteric and portal vein thrombosis, which occasionally causes ileus.

Key words
mesenteric and portal vein thrombosis, ileus, internal intestinal fistula

Reprint requests
Kenichiro Saito Department of Surgery, Toyama Red Cross Hospital
2-1-58 Ushijimahonmachi, Toyama, 930-0859 JAPAN

Accepted
May 30, 2007

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