虫垂炎術後の遺残膿瘍に合併した上腸間膜静脈血栓症の1例

概要

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A 51-year-old man was admitted to the hospital because of abdominal pain lasting for 2 days, and was performed an appendectomy with a diagnosis of acute appendicitis. A high temperature run with acute liver dysfunction on the 9th postoperative day, and an abdominal computed tomography revealed a cystic lesion at the ileocecal region and central lucency at the superior mesenteric vein. He was diagnosed as having an abscess and superior mesenteric vein thrombosis (SMVT). Antibiotics were administrated, but in vain. Therefore an emergency drainage was performed on the 16th postoperative day. At surgery, there was no ischemic change on the small intestine but an abscess, and so we inserted a drainage tube to the abscess cavity without thrombectomy through the superior mesenteric vein. No anticoagurant therapy was given. SMVT changed for the better gradually according to an improvement of the abscess due to the drainage. A remedy for this rare disease has not been established as yet. It is suggested that cure of SMVT due to an intraabdominal inflammatory disease can be anticipated according to an improvement of the primary lesion. Enhanced computed tomography entertaining this disease is recommended when a patient become feverish and/or have acute liver dysfunction after appendectomy.
新潟大学の論文