Idiopathic Superior Mesenteric Venous Thrombosis in a Young Man : A Case Report

[ABSTRACT] Idiopathic thrombosis of the superior mesenteric vein (SMV) is defined as an unexplained thrombotic event without an apparent cause. We herein report a case of idiopathic SMV thrombosis in a young man who was successfully treated without surgery. A 32-year-old man without any previous diseases had epigastric pain and was admitted to The Jikei University, Daisan Hospital, when acute SMV thrombosis was diagnosed through computed tomography with contrast enhancement. Computed tomography also revealed blood flow to the intestine without ascites. Moreover, because physical and laboratory findings had suggested a low probability of peritonitis due to intestinal necrosis, treatment with warfarin was started, following an initial treatment with heparin. Not observed were abnormalities of blood test results or predisposing factors, such as steroid, trauma, liver cirrhosis, inflammatory bowel disease, and abdominal surgery. Therefore, idiopathic SMV thrombosis was diagnosed. The patient was discharged without invasive procedures or complications after being hospitalized for 21 days. Idiopathic SMV thrombosis should be considered in the differential diagnosis of life-threatening conditions presenting with acute abdomen. If a patient with SMV thrombosis does not present with peritonitis, a useful treatment may be prompt anticoagulation therapy.