Introduction: The superior mesenteric vein is the most prevalent location of thrombosis development in acute mesenteric venous thrombosis, which is a rare disorder. The Virchow trinity of endothelial damage, stasis, and hypercoagulability is usually disrupted in patients who are prone to this illness. The acute variant is characterised by intestinal ischaemia, making it difficult to diagnose before intestine gangrene occurs. A delayed diagnosis due to poor investigative ability results in patients suffering from acute renal failure and a high mortality rate, according to the limited experience with this ailment in the East African region. As a result, the goal of this research was to describe the presentation and treatment of four patients with mesenteric venous thrombosis in an East African referral hospital, followed by a review of the aetiology, clinical characteristics, and management of this illness.
Methods: Over the course of 18 months, a descriptive retrospective review of four patients was performed. From the patients' clinical files, demographic and clinical data were collected, and manual analysis was performed using a spreadsheet.
Four cases were identified over the course of 18 months. Acute symptoms persisted for 5 to 21 days in all patients, indicating a delay in diagnosis. Short bowel syndrome and severe renal failure killed two patients within 30 days of surgery. Two patients survived short bowel syndrome complications and one patient survived severe renal injury that necessitated dialysis.
This brief case series is characterised by a delay in the diagnosis of acute MVT. As a result, all of the cases had gangrenous bowel, which contributed to the high fatality rate. Anticoagulation prevents the spread of a clot in the veins, which is linked to a lower risk of death and recurrence. To avoid bowel with dubious viability, thrombolysis and thrombectomy might be considered in some cases. The mortality rate from MVT has reduced over the last four decades, and it now stands at 10-20%, however there isn't enough data in East Africa to make this determination.
Author (S) Details
Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.
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