MESENTERIC VENOUS THROMBOSIS LEADING TO SMALL BOWEL NECROSIS IN A VIETNAMESE PATIENT WITH PROTEIN C DEFICIENCY: A CASE REPORT
Main Article Content
Abstract
Mesenteric venous thrombosis (MVT) is a rare but life-threatening cause of acute abdominal
pain, particularly when associated with congenital protein C deficiency. We present a 65-year-old
Vietnamese man with acute epigastric and periumbilical pain and loose stools. Though initially
hemodynamically stable, he showed signs of peritonitis. Laboratory findings revealed
leukocytosis and elevated D-dimer. Contrast-enhanced CT confirmed complete thrombosis of the
superior mesenteric vein, partial portal vein thrombosis, and bowel wall edema. Protein C
activity was reduced to 50%. The patient underwent emergency laparotomy with resection of one
meter of necrotic bowel and creation of a double-barrel ileostomy. He received postoperative
anticoagulation with enoxaparin, later switched to apixaban. Discharged in stable condition on
postoperative day 14, he showed resolution of portal vein thrombosis at one-month follow-up.
This case underscores the importance of early imaging, recognition of inherited thrombophilia,
and timely surgical and anticoagulant therapy in managing MVT.
Article Details
Keywords
Protein C deficiency; Mesenteric venous thrombosis; Small bowel necrosis; Inherited thrombophilia.
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