Özet:

OBJECTIVE: Mesenteric venous thrombosis is seen in 5-15% of acute mesenteric ischemia patients. Mesenteric venous thrombosis is generally related to hypercoagulation disorders and proteinCdeficiency, which is a hypercoagulation disorder and one of the important risk factors for mesenteric venous thrombosis development. In this study, we investigated 4 cases of mesenteric venous thrombosis related to protein C deficiency. CASES: Cases included 2 male and 2 female patients and the main symptom was abdominal pain. The patients with physical examination findings of acute abdomen undergone emergency laparotomy. During operation, following resection of necrotic part of bowel; in Case 1, jejunojejunal anastomosis; in Case 2 end jejunostomy and in Case 3 double jejunocolic ostomy were performed. In one patient, mesenteric venous thrombosis was diagnosed by abdominal tomography without any finding of acute abdomen. This patient had 5000 U bolus and 10000 U/h heparin infusions for 10 days. Hypercoagubility tests' results for Protein C levels were as 42.20%, 38.50% , 35.40% and 29.25%, for Cases 1-4, respectively. All patients had low molecular heparin initially then continued with warfarin therapy. CONCLUSION: Etiology of mesenteric venous thrombosis must be investigated in patients diagnosed with mesenteric venous thrombosis. Protein C deficiency is one of the important risk factors of mesenteric venous thrombosis development. Laparotomy is necessary in patients with intestinal necrosis whereas patients without intestinal necrosis might be followed with nonoperative treatment.

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