Mesenteric venous thrombosis (MVT) is a blood clot in one or more of the major veins that drain blood from the intestine. The superior mesenteric vein is most commonly involved.

Causes

MVT is a clot that blocks blood flow in a mesenteric vein. There are two such veins through which blood leaves the intestine. The condition stops the normal blood circulation of the intestine and can result in damage to the intestine.

The exact cause of MVT is unknown. However, there are many diseases that can lead to MVT. Many of the diseases cause swelling (inflammation) of the tissues surrounding the veins, and include:

• Appendicitis
• Cancer of the abdomen
• Diverticulitis
• Liver disease with cirrhosis
• High blood pressure in the blood vessels of the liver
• Abdominal surgery or trauma
• Pancreatitis
• Inflammatory bowel disorders (Crohn disease and ulcerative colitis)
• Heart failure

  Heart failure

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People who have disorders that make the blood more likely to stick together (clot) have a higher risk for MVT and include:

• Protein C or S deficiencies
• Polycythemia vera
• Essential thrombocythemia

Birth control pills and estrogen medicines also increase risk.

MVT is more common in men than women. It mainly affects middle aged or older adults.

Symptoms

Symptoms may include any of the following:

• Abdominal pain, which may get worse after eating and over time

  Abdominal pain

  Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.

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• Bloating
• Constipation
• Bloody diarrhea
• Fever
• Septic shock
• Lower gastrointestinal bleeding
• Vomiting and nausea

Exams and Tests

A CT scan is the main test used to diagnose MVT.

Other tests may include:

• Angiogram (studying the blood flow to the intestine)

  Angiogram

  An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...

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• MRI of the abdomen

  MRI of the abdomen

  An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...

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• Ultrasound of the abdomen and mesenteric veins

Treatment

Blood thinners are used to treat MVT when there is no associated bleeding. In some cases, medicine can be delivered directly into the clot to dissolve it. This procedure is called thrombolysis.

Less often, the clot is removed with a type of surgery called thrombectomy.

If there are signs and symptoms of a severe infection called peritonitis, surgery to remove the injured part of the intestine is done. After surgery, an ileostomy (opening from the small intestine into a bag on the skin) or colostomy (an opening from the colon into the skin) may be needed.

Outlook (Prognosis)

The outlook depends on the cause of the thrombosis and any damage to the intestine. Getting treatment for the cause before the intestine has died can result in a good recovery.

Possible Complications

Intestinal ischemia is a serious complication of MVT. Part or all of the intestine dies because of poor blood supply.

When to Contact a Medical Professional

Contact your health care provider if you have severe or repeated episodes of abdominal pain.

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