Mesenteric venous thrombosis

[mosler]

Was diagnosed with this a year & a half ago after a year of abdominal pain they thought was IBD.  Been on coumadin, but while it gave some relief during the first year, now I have pain all the time & the only relief I get is when I stop eating.  I've seen a gastroenterologist, had an unbelievable # of scans & tests, and they say all they can do for me now is give me heavy painkillers.  I just don't
understand why they don't take the clot out, or do a bypass, or something!  I'm frustrated.  I've asked them about surgery & am just told it's not an option with no further explanation.  I did my own research & found a procedure called percutaneous transhepatic thrombectomy, and asked for it but was told it was "too controversial a procedure" even tho' I found many medical journal articles showing how successful its been.  Taking narcotics isn't a solution.  I feel like they've given a death sentence to me.  Am I expecting too much?  Should I just accept what they told me & get prepared for the worst?

[mosler]

Thanks.  I think what I really needed was a detailed explanation, and you gave me that.  As strange as it seems, I'm a lot more content now.  I just wish my doctors would be more forthcoming with information.

[Christopher R Watters, MD]

I am sorry to hear of your difficult situation. The natural history of a clot in any vein is to either dissolve through natural processes or to "organize" which means it turns into scar, effectively shutting down the vessel. A thrombectomy can only be performed before the clot sticks to the wall of the vein which usually means within a few days to a week or two of its formation. A surgical bypass to decompress the system depends on the anatomy of the blockage. If the clot includes not only the portal vein but also the tributaries this would not be an optin because it would only decompress a small portion of the mesenteric bed.