Beckermann J, Walker A, Grewe B, Appel A, Manz J. Mesenteric venous thrombosis complicating acute appendicitis: A case series.
Int J Surg Case Rep 2020;
73:100-104. [PMID:
32652248 PMCID:
PMC7352057 DOI:
10.1016/j.ijscr.2020.06.099]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/06/2020] [Accepted: 06/20/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION
Acute appendicitis is one of the most common surgical conditions. In the current era it rarely presents in association with mesenteric venous thrombosis. We present 4 cases of mesenteric venous thrombosis occurring in the setting of acute appendicitis.
METHODS
We performed a retrospective review of Mayo Enterprise clinical database for inpatients with a diagnosis of acute appendicitis and venous thrombosis related ICD-10 codes. Charts for patients with a diagnosis of mesenteric venous thrombosis and acute appendicitis were reviewed to identify demographic data, findings at presentation, and management patterns.
RESULTS
A total of 1,615 inpatients were identified with a principle diagnosis of acute appendicitis across the Mayo Enterprise from October 1st, 2015- March 31st, 2019. Four inpatients with a diagnosis of acute appendicitis were also noted to have a mesenteric venous thrombosis at presentation resulting in an incidence of 0.25 %. Mean duration of symptoms at presentation was 12.25 days. All patients with acute appendicitis and mesenteric venous thrombosis were initially managed with a heparin drip, antibiotics, and intravenous fluids. Ultimately, 3 of 4 patients underwent appendectomy.
CONCLUSION
Mesenteric venous thrombosis complicating acute appendicitis is rare and typically presents in a delayed fashion. Patients without evidence of non-viable bowel are typically treated initially with intravenous fluid resuscitation, antibiotics, bowel rest, and anticoagulation with a heparin drip.
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