Intest Res.  2014 Apr;12(2):157-161. 10.5217/ir.2014.12.2.157.

Superior Mesenteric Vein Thrombosis as an Early Presentation of Myelodysplastic Syndrome: A Case Report

• Kim MJ
• Song HJ
• Kim WK
• Kim SH

• KMID: 2284902
• DOI: http://doi.org/10.5217/ir.2014.12.2.157

Abstract

Mesenteric venous thrombosis (MVT) is a serious condition due to its potential association with mesenteric ischemia and infarction of the small bowel. Symptoms of MVT are often vague, making accurate diagnosis and sufficient treatment difficult. However, increased awareness and new imaging modalities for this condition have improved outcomes for patients with MVT. Treatment includes anticoagulation, transcatheter therapy, and surgery. In the present report, we describe the case study of a 62-year-old woman with a presenting diagnosis of superior MVT, who was finally diagnosed with myelodysplastic syndrome. The superior MVT spontaneously dissolved after the patient underwent 6 months of systemic anticoagulation therapy. Invasive surgery or bowel resection was not required.

Keyword

Mesenteric vein; Thrombosis; Myelodysplastic syndrome

MeSH Terms

Diagnosis
Female
Humans
Infarction
Ischemia
Mesenteric Veins*
Middle Aged
Myelodysplastic Syndromes*
Thrombosis*
Venous Thrombosis

Figure

• 

  Fig. 1 Abdominal-pelvic CT findings. (A) At admission, axial CT showed thrombosis (white arrow) in the superior mesenteric vein (SMV) and its tributary. (B) Coronal CT showed a moderate amount of ascites with omental and mesenteric infiltrations associated with SMV thrombosis; the thrombus was 4.5 cm in length (white arrow). (C) CT findings after 6 months of anticoagulation therapy showed complete resolution of the SMV thrombosis (white arrow), (D) coronal CT image after 6 months of anticoagulation therapy.

• 

  Fig. 2 Bone marrow aspirate smear (Wright stain, ×1000). (A) Dysplastic erythroid precursors with multinuclearity and megaloblastic changes. (B) Dysplastic large neutrophils with bilobed nuclei.

• 

  Fig. 3 Capsule endoscopic (CE) findings. CE findings showed moderate small bowel wall edema from the distal jejunum to the ileum. Severe mucosal edema with erythematous patches in the ascending colon was also observed.

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