Ileum Penetration and Stenosis due to SMV Thrombosis treated by Elected Surgery

Katsunori Sakamoto, Masahiro Uehara, Ichiro Tamaki, Dai Manaka and Masashi Noguchi

Department of Surgery, Kyoto Katsura Hospital

A 73-year-old man with acute abdomen was found in abdominal enhanced Computed Tomography (CT) to have a thrombosis of the SMV. Because of a lack of symptomatic intestinal necrosis, we started systemic thrombolytic therapy with heparin and urokinase. Successful thrombolytic therapy, ileus and abscess formation due to cicatricial ileum stenosis and ileum penetration were occurred. Ileus and the abscess were controlled with long-tube decompression and antibiotic administration. We then conducted partial intestine and sigmoid colon resection. The postoperative course was good and no recurrence was seen in subsequent warfalin therapy. SMV thrombosis is comparatively rare disease, but sometimes ileum stenosis may occur in conservative therapy like our case. Our case comorbid abscess formation, but we controlled ileus and infection conservatively to conduct elective surgery.

Key words
SMV thrombosis, ileum stenosis

Reprint requests
Katsunori Sakamoto Department of Surgery, Kyoto Katsura Hospital
17 Yamadahirao-cho, Nishikyou-ku, Kyoto, 615-8256 JAPAN

Accepted
February 18, 2009

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