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Mesenteric venous thrombosis as a complication of appendicitis in an adolescent: A case report and literature review

Authors
 Seo Hee Yoon  ;  Mi-Jung Lee  ;  Se Yong Jung  ;  In Geol Ho  ;  Moon Kyu Kim 
Citation
 MEDICINE, Vol.98(48) : e18002, 2019 
Journal Title
MEDICINE
ISSN
 0025-7974 
Issue Date
2019
MeSH
Acute Disease ; Adolescent ; Anti-Bacterial Agents/therapeutic use ; Anticoagulants/therapeutic use ; Appendectomy/methods ; Appendicitis/complications* ; Appendicitis/therapy ; Humans ; Male ; Mesenteric Ischemia/diagnostic imaging ; Mesenteric Ischemia/etiology ; Mesenteric Ischemia/therapy* ; Mesenteric Veins/diagnostic imaging ; Mesenteric Veins/surgery* ; Tomography, X-Ray Computed ; Ultrasonography
Abstract
RATIONALE:

Mesenteric venous thrombosis is an uncommon but potentially fatal condition that can cause bowel ischemia. It results from a systemic hypercoagulable state or abdominal infection draining into the portal venous system. Several cases regarding portomesenteric venous thrombosis as a complication of appendicitis were reported in adults, but there are far fewer reports in pediatric patients. The mortality rate of the condition is high if untreated, especially in children, reaching up to 50%.

PATIENT CONCERNS:

A healthy 15-year-old male with no significant past medical history presented with right lower quadrant pain, lethargy, and fever. The computed tomography scan showed a focal thrombosis at the superior mesenteric vein branch and an inflamed appendix.

DIAGNOSES:

Mesenteric venous thrombosis complicating acute appendicitis.

INTERVENTIONS:

Intravenous antibiotics along with anticoagulants and laparoscopic appendectomy OUTCOMES:: After 1 month, a follow-up ultrasonography revealed full resolution of the thrombosis.

LESSONS:

Appendicitis is one of the most frequently encountered causes of pediatric surgical emergencies; therefore, physicians should be conscious of mesenteric venous thrombosis as a possible complication of acute appendicitis, irrespective of whether patients have thrombophilic conditions or not.
Files in This Item:
T201904991.pdf Download
DOI
10.1097/MD.0000000000018002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Moon Kyu(김문규) ORCID logo https://orcid.org/0000-0001-6186-3991
Yoon, Seo Hee(윤서희) ORCID logo https://orcid.org/0000-0002-8361-9815
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Jung, Se Yong(정세용) ORCID logo https://orcid.org/0000-0003-1337-563X
Ho, In Geol(호인걸)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174590
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