Mesenteric vein thrombosis associated with anti-thrombin III deficiency.

Acute mesenteric ischaemia presents infrequently in clinical practice accounting for 1–2 cases per 1000 hospital admissions per year1. Of these, mesenteric vein thrombosis (MVT) is responsible for between 5% and 15% of intestinal ischaemic events2. Primary mesenteric vein thromboses are typically seen in patients with thrombophilias due to protein C, protein S and anti-thrombin III deficiency. Approximately 2% of primary MVT cases are caused by anti-thrombin III deficiency3. Secondary MVT is commonly seen post-operatively, with oral contraceptive use, trauma or in paraneoplastic syndromes. Despite advances in diagnostic techniques and management of this disease, the prognosis remains poor with mortality rates ranging from 20% to 93%2,4. We describe a case of primary MVT attributable to anti-thrombin III deficiency.