Superior mesenteric vein thrombosis after bowel resection in patients with inflammatory bowel disease.

Superior mesenteric vein thrombosis is one of many causes of mesenteric ischemia and may occur after intestinal surgery in patients with inflammatory bowel disease. While hypercoagulability is a known complication of inflammatory bowel disease, other risk factors may also coexist and play a role in the development of superior mesenteric vein thrombosis. The true etiology of hypercoagulability that seems to be present in the face of inflammatory bowel disease is unknown but thought to be related to multiple factors including vitamin deficiency, the inflammatory process, prothrombotic conditions, hypercoagulable states, and other abnormalities of coagulation. Symptoms of superior mesenteric vein thrombosis are often vague, leading to a delay in diagnosis, increasing not only the mortality rate but also the need for surgical intervention rather than medical management. Once diagnosed, patients are managed with anticoagulation alone or in combination with surgical intervention. Most patients improve and will continue anticoagulation therapy ranging from 3 months to lifelong treatment, depending on the origin of the hypercoagulable state and the extent of condition.