FACTORS PREDICTING TRANSMURAL NECROSIS IN PATIENTS WITH ACUTE MESENTERIC VENOUS THROMBOSIS

Background:
To determine the clinical, laboratory, and computed tomography (CT) findings that indicate transmural necrosis in patients with acute mesenteric venous thrombosis (AMVT).
Methods:
We used the electronic records and CT scans of the patients hospitalized between 2014 and 2020 with the diagnosis of acute mesenteric ischemia due to AMVT. Various parameters were compared between The patients who had transmural necrosis on laparotomy and those without transmural necrosis who could be discharged from the hospital.
Results:
From 51 patients, 18 underwent laparotomy. Among them 13 had transmural necrosis whereas, 5 patients had normal or ischemic bowel. 33 completed conservative therapy.
Among the clinical findings, obstipation, and among the laboratory findings, the mean level of white blood cells, creatinine, urea, and lactate dehydrogenase were higher in the transmural necrosis group. Comparing the CT scan findings, the mean diameter of the abnormal loop, and diameter of the bowel loop proximal to the abnormal loop were higher in the patients with transmural necrosis. Also, these radiologic findings were more prevalent in the transmural necrosis group: Loculated fluid beside abnormal loop, bowel wall thickening, adjacent focal mesenteric haziness, foci with decreased enhancement, and pneumatosis intestinalis.
Among 32 patients with abnormal bowel wall thickening, the diameter of the abnormal loop, the diameter of the bowel loop proximal to the abnormal loop, and adjacent focal mesenteric haziness were higher in those with transmural necrosis.
Conclusion:
Clinical, Laboratory, And Radiologic Findings Could Be Used To Differentiate Transmural Necrosis From Non-Transmural Necrosis In Patients With AMVT.