Superior Mesenteric venous thrombosis in a patient with protein C deficiency

2018 
Mesenteric venous thrombosis causing small-bowel infarction is an extremely rare cause of acute abdomen and often difficult to diagnose. Both congenital and acquired causes are responsible. Protein C deficiency is a rare genetic abnormality that predisposes the patient to thrombophilia and leads to thrombosis, often at unusual sites. It mimics clinically with many differentials.1 This paper presents a case of superior mesenteric venous thrombosis caused by protein C deficiency, which is a rare disease. A 68-year-old foreigner female presented with complaints of constant, diffuse abdominal pain of 7 days associated with nausea, vomiting, and anorexia. Even with all sorts of conservative management, pain was not subsiding. Contrasted computed tomography of the abdomen revealed SMV thrombosis. Immediate anticoagulant was started & hypercoagulability workup revealed protein C deficiency. It is concluded that the mesenteric venous thrombosis might be caused by underlying protein C deficiency, while protein S and antithrombin III levels were normal. Bangladesh Crit Care J March 2018; 6(1): 50-53
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