Abstract

Mesenteric vein thrombosis (MVT) is not an uncommon cause of acute mesenteric ischemia yet its diagnosis is often delayed due to its nonspecific abdominal symptoms, low incidence, and low awareness among clinicians. A 21-year-old man who underwent splenectomy after a traumatic injury four years prior to presentation, presented with subacute epigastric pain associated with mild fever, not responding to symptomatic treatment. Based on the initial imaging studies done, he was found to have mesenteric vein thrombosis. Further workup showed myeloproliferative syndrome with JAK2 mutated wild type allele. The patient was successfully treated with long term anticoagulant. Three months later, control studies documented the disappearance of thrombotic lesions. This report is to highlight the importance of suspecting a MVT in patients with unexplained recurrent abdominal pain and looking for specific etiologies for secondary MVT such as JAK2 mutation even if the patient has an obvious reason for thrombocytosis.