CASE REPORT article
Front. Surg.
Sec. Visceral Surgery
Acute Mesenteric Vein Thrombosis and Small-Bowel Infarction Complicated by Essential Thrombocythemia: A case report
Provisionally accepted
- 1Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan ,Shandong Province, China
- 2Department of Cardiology, The 960 Hospital of the Joint Logistics support Force of the Chinese people's Liberation Army, Jinan,Shandong Province, China
- 3Qilu Hospital, Shandong University, Jinan, China
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Rationale: Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm. Cavernous transformation of the portal vein (CTPV), esophagogastric variceal (EGV) rupture hemorrhage, and particularly intestinal necrosis as complications of ET are extremely rare. Our case report explores a complex case of thrombocythemia complicated by portal cavernous transformation and intestinal necrosis. Patient concerns: In this case report, a middle-aged female patient with a history of ET presented with acute severe abdominal pain. And during the subsequent therapeutic course, she developed small bowel perforation, necrosis, and EGV rupture hemorrhage. Diagnoses: Contrast-enhanced computed tomography (CT) revealed mesenteric venous thrombosis and CTPV. Interventions: The multimodal interventions including indirect thrombolysis, anti-infective therapy, abdominal drainage, partial small bowel resection, double-barrel enterostomy, endoscopic sclerotherapy, splenic artery embolization and repeated sclerotherapy were initiated. Outcomes: The patient achieved clinical stabilization and the fistula was returned. Lessons: This case emphasize the importance of maintaining vigilance for the progression of ischemic bowel disease and the "thrombosis-ischemia" vicious cycle in this patient population.
Keywords: Essential thrombocythemia, Intestinal Perforation, Mesenteric ischemia, Thrombosis, Varicose Veins
Received: 11 Sep 2025; Accepted: 23 Jan 2026.
Copyright: © 2026 Xu, Liu, Zhang and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanbo Yu
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