Superior mesenteric vein thrombosis: how a family medicine physician's knowledge of a patient helped save a life

Abstract

This case illustrates the clinical difficulty in making the diagnosis of mesenteric ischemia and in particular superior mesenteric venous thromboembolism. There is no definitive sign, symptom, laboratory or diagnostic criteria to establish the diagnosis, rather a constellation of data along with clinical judgment must be utilized for quick recognition and treatment. In this case although the delay in care was minimal and the patient was taken to surgery in a timely manner he still suffered the comorbid complications of respiratory and hepatic failure. Familiarity of the patient and high clinical suspicion still remain the most vital tools when diagnosing mesenteric ischemia. The family physician's knowledge of, and long-term relationship with the patient, certainly averted a possibly morbid outcome.