Abstract
Chronic nonischemic disturbance of mesenteric venous blood flow is reported in 11 patients with a mean age of 19 years. This entity, rarely discussed n the literature, is different from acute thrombosis and chronic thrombotic forms with portal hypertension or hypercoagulopathy. In eight patients this syndrome was secondary to organic lesions of different origin: mesenteric vein squeezed by fibrous bands or an abnormal jejunal artery (four cases), lymphoma involving the distal superior mesenteric veins (three cases), hemangioma causing microthrombi (one case). In three patients no etiology or predisposing factor was found. All patients presented with rectal hemorrhage. Small bowel enema showed a constant pattern in 11 patients: small nodules, modified by compression or peristalsis, involving the mesenteric border of the jejunoileal segment, and associated with thick, straight but regular folds. Mesenteric varices were suspected and led to angiographic studies which were normal in three cases, confirmed varices in eight cases, and thrombosis in four cases. Laparotomy was normal in three cases and established the etiological diagnosis in eight cases. Varices were shown in six cases. Arteriography and laparotomy were unable to reach a complete diagnosis.
Similar content being viewed by others
References
Clemmett AR, Chang J. The radiologic diagnosis of spontaneous mesenteric venous thrombosis. Am J Gastroenterol 1975;63:209–215
Grendell JH, Ockner RK. Mesenteric venous thrombosis. Gastroenterology 1982;82:358–372
Harward TRS, Green D, Bergan JJ, Rizzo RJ, Yao JT. Mesenteric venous thrombosis. J Vasc Surg 1989;9:328–333
Soper NJ, Rikkers LF, Miller FJ. Gastrointestinal hemorrhage associated with chronic mesenteric venous occlusion. Gastroenterology 1985;88:1964–1967
Goldberg HI, Sheft DY. Abnormalities in small intestine contour and caliber. A working classification. Radiol Clin North Am 1976;14:461–475
Herlinger H, Maglinte D, eds. Clinical radiology of the small intestine. Philadelphia: W.B. Saunders, 1989
Warren WD, Millikan WJ, Smith RB. Noncirrhotic portal vein thrombosis. Ann Surg 1980;192:341–349
Little AG, Moossa AR. Gastrointestinal hemorrhage from left sided portal hypertension. Am J Surg 1981;141:153–158
Berry FB, Bougas JA. Agnogenic venous mesenteric thrombosis. Ann Surg 1950;132:450–474
Mathews JE, White RR. Primary mesenteric venous occlusive disease. Am J Surg 1971;122:579–583
Anane-Sefah JC, Blair E, Reckler S. Primary venous occlusive disease. Surg Gynecol Obstet 1975;141:740–752
Wilson C, Walker ID, Davidson JF, Imrie CW. Mesenteric venous thrombosis and antithrombin III deficiency. J Clin Pathol 1987:40:906–908
Green D, Ganger DR, Blei AT. Protein C deficiency in splanchnic venous thrombosis. Am J Med 1987;82:1171–1174
Broekmans AW, Van Rooyen W, Westerveld BD, Briet E. Mesenteric vein thrombosis as presenting manifestation of hereditary protein S deficiency. Gastroenterology 1987;92:240–242
Radin DR, Siskind BN, Alpert S, Bernstein RG. Small bowel varices due to mesenteric metastasis. Gastrointest Radiol 1986;11:183–184
Maglinte D, Lappas JC, Kelvin FM, Rex D, Chernish SM, Small bowel radiography: how, when and why? Radiology 1987;163:297–305
Boverie JH, Hock D, Longtain F. Radiography of the small intestine in Crohn's disease: barium meal or enteroclysis. Acta Gastroent Belg 1988;50:521–531
Gray JE, Ragozzino MW, Van Lysel MS, Burke TM. Normalized organ doses for various diagnostic radiologic procedures. AJR 1981;137:463–470
Agarwal D, Scholz FJ. Small bowel varices demonstrated by enteroclysis. Radiology 1981;140:350–355
Rosen A, Korobkin M, Silverman PM, Dunnick NR, Kelvin FM. Mesenteric vein thrombosis: CT identification. AJR 1984;143:83–86
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boverie, J.H., Counet, D., Meunier, P. et al. Small bowel enema and diagnosis of chronic nonischemic disturbance of superior mesenteric venous blood flow. Abdom Imaging 18, 265–270 (1993). https://doi.org/10.1007/BF00198119
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF00198119