Ischemic intestinal stenosis complicated with portal and superior mesenteric vein thrombosis: Case reports and literature review.

Background: The main complication of the portal vein (PV) and superior mesenteric vein (SMV) thrombosis is intestinal infarction due to acute intestinal ischemia. However, in a small number of cases, chronic ischemia-induced bowel stenosis also occurs, and there are no published articles with a comprehensive literature review on this late complication. Therefore, we aimed to clarify the progression and clinical features of intestinal stenosis which is caused by thrombosis of the PV and SMV, and to share therapeutic experience.

Methods: We report 4 cases of ischemic intestinal stenosis occurring 4-8 weeks after successful treatment of PV and SMV thrombosis, and retrospectively analyzed the literature from 1990 to July 2024 for relevant cases to report. Methods: All 4 patients were admitted to the hospital due to abdominal pain and were diagnosed with ischemic intestinal stenosis complicated with PV and SMV thrombosis through imaging studies. Methods: The 4 patients received thrombolytic and anticoagulant therapy due to PV and SMV thrombosis. Subsequently, they underwent partial small bowel resection and double enterostomy because of the development of intestinal stenosis.

Results: Postoperative follow-up was conducted for the patients. Three patients underwent enterostomy reduction with a favorable prognosis, while 1 patient was lost to follow-up.

Conclusions: Patients with PV and SMV thrombosis should receive prompt anticoagulant or interventional therapy. In addition, closer follow-up should be carried out to ensure an earlier diagnosis of ischemic intestinal stenosis, leading to more timely treatment and a better prognosis.