Mesentery Venous Thrombosis In First Trimester:a Case Report And Literature Review

Objective:To disscuss the clinical features and therapy for mesenteric venous thrombosis in first trimester of pregnancy.Method:One case of venous thrombosis mesenteric in first trimester of pregnancy was reported in the 3rd Hospital of Cixi in 2016.The author reviewed relevant literature from 1996 to 2016 at home and abroad,4 cases of this disease were collected and retrospectively analyzed.Result:The incidence of gestational age ranged from 6 to 12 weeks.4 cases initially manifesting abdominal pain,and with various degrees of nausea,vomiting and other symptoms,of which 2 cases were misdiagnosed as abortion and acute pancreatitis.1 case has a history of splenectomy,1 case of antithrombin deficiency,1 case of protein S deficiency.All patients were diagnosed by Doppler ultrasound,CT or surgery,1 case was cured by low-molecular-weight heparin antithrombotic therapy,3 patients performed necrotizing bowel resection and intestinal anastomosis.All maternal prognosis was good,in which 1 case of pregnancy continued to full-term labor after operation,1 case occurred after the medical abortion,and 2 cases chose to abortion termination after stabilization on thrombosis.Conclusion:Venous thrombosis mesenteric in First Trimester is extremely rare,and thrombophilia is the main cause.There are no specific clinical manifestations of this disease,its main manifestation is abdominal pain,and the diagnosis of this disease needs to be judged synthetically and based on clinical manifestations and auxiliary examination,and CT embraced the greatest value of diagnostic.For those patients who present abdominal pain at the early stage of pregnancy and risk easy to embolism,they should be identified as soon as possible and be excluded.In suspected cases,comprehensive treatment,which is mainly about low-molecular-weight heparin anticoagulation,should be used as early as possible;and for those patients who presented severe peritonitis symptoms during the treatment,timely surgical exploration and removal of necrotic bowel are the key to ensuring the safety of mother and child.