Comparison of acute mesenteric arterial thromboembolism and mesenteric venous thrombosis.
| . | Arterial Thromboembolism . | Venous Thrombosis . |
|---|---|---|
| *Adapted from Kumar et al.20 20 | ||
| Risk factors | Atherosclerotic vascular disease | Hypercoagulable states |
| Hypertension | Inflammatory bowel disease | |
| Smoking | Abdominal cancer | |
| Valvular heart disease | ||
| Atrial fibrillation | ||
| Clinical features | ||
| Age of patient | Older patients (60s-70s) | Younger patients (40s-50s) |
| Abdominal pain | Abrupt onset | Insidious onset |
| Diagnostic tests | Mesenteric angiography usually required | Abdominal computed tomography scan |
| Anatomic involvement | Superior and inferior mesenteric arteries | Superior mesenteric veins |
| Therapy | ||
| Surgery | Revascularization +/– bowel resection | Observation; surgery generally not required |
| Thrombolysis | Sometimes useful | Generally not useful |
| Long-term anticoagulation | Indicated | Indicated |
| Prognosis | High acute mortality rate | Better prognosis |
| Long-term sequelae | Short bowel | Short bowel |
| Varices | ||
| . | Arterial Thromboembolism . | Venous Thrombosis . |
|---|---|---|
| *Adapted from Kumar et al.20 20 | ||
| Risk factors | Atherosclerotic vascular disease | Hypercoagulable states |
| Hypertension | Inflammatory bowel disease | |
| Smoking | Abdominal cancer | |
| Valvular heart disease | ||
| Atrial fibrillation | ||
| Clinical features | ||
| Age of patient | Older patients (60s-70s) | Younger patients (40s-50s) |
| Abdominal pain | Abrupt onset | Insidious onset |
| Diagnostic tests | Mesenteric angiography usually required | Abdominal computed tomography scan |
| Anatomic involvement | Superior and inferior mesenteric arteries | Superior mesenteric veins |
| Therapy | ||
| Surgery | Revascularization +/– bowel resection | Observation; surgery generally not required |
| Thrombolysis | Sometimes useful | Generally not useful |
| Long-term anticoagulation | Indicated | Indicated |
| Prognosis | High acute mortality rate | Better prognosis |
| Long-term sequelae | Short bowel | Short bowel |
| Varices | ||