Hybrid Surgery for Superior Mesenteric Vein Thrombosis: A Case Report

Superior mesenteric vein thrombosis (SMVT) is a rare condition characterized by thrombus formation in the superior mesenteric vein. SMVT is generally caused by abnormal blood coagulation, inflammation, or surgical interventions. This condition can lead to intestinal ischemia and necrosis due to blood flow stasis. We report the case of a man in his 60s who presented with abdominal pain and vomiting. Abdominal contrast-enhanced computed tomography shows a thrombus in the portal and superior mesenteric veins, and reduced contrast in the small intestine. Approximately 1.5 m of the necrotic jejunum was resected, an open management approach was undertaken, and anticoagulation with continuous intravenous heparin was initiated. On the fourth day of treatment, a thrombus was retrieved from the superior mesenteric vein within the main trunk of the portal vein using a stent clot retrieval device. The patient's bowel edema improved soon thereafter. This case of SMVT was successfully managed using a hybrid approach of bowel resection and transcatheter thrombus retrieval.