Increased activity of Factor VIII causing acute intestinal ischemic disorder with recurrent and multiple arterial thromboses

Research output: Contribution to journalArticle

Abstract

Acute intestinal ischemic disorders are potentially life threatening, making early diagnosis and emergency surgery crucial. Although hypercoagulability may induce mesenteric venous thrombosis, its association with mesenteric arterial thromboembolism remains controversial. We present the case of a 52-year-old man with hypercoagulability-induced acute arterial occlusive mesenteric ischemia. The patient suffered from arterial occlusive mesenteric ischemia, recent ischemic stroke, and previous renal infarction. He had no history of atrial fibrillation, atherosclerosis, vascular diseases, autoimmune diseases, malignancy, liver diseases, copper deficiency, or other risk factors for arterial thromboembolism. Segmental resection of the gangrenous bowel with primary end-to-end anastomosis was performed. A pathological examination revealed multiple thrombi within the mesenteric arteries of the infarcted bowel without apparent atherosclerosis of the vessels. The plasma level of factor VIII was high even 64 months postoperatively, which may have contributed to the recurrent and multiple arterial thromboses. A lifelong oral anticoagulation therapy was suggested. From our experience, we recommend that thrombophilia screening be performed in patients with acute intestinal ischemic disorders, particularly in those with a history of recurrent or multiple thromboembolism. Anticoagulant therapy should be prescribed for those with hypercoagulability.

Original languageEnglish
Pages (from-to)177-180
Number of pages4
JournalFormosan Journal of Surgery
Volume48
Issue number5
DOIs
Publication statusPublished - 2015 Oct 1

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Thrombophilia
Factor VIII
Thromboembolism
Thrombosis
Atherosclerosis
Mesenteric Arteries
Vascular Diseases
Anticoagulants
Atrial Fibrillation
Infarction
Autoimmune Diseases
Liver Diseases
Copper
Early Diagnosis
Emergencies
Stroke
Kidney
Therapeutics
Mesenteric Ischemia
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Increased activity of Factor VIII causing acute intestinal ischemic disorder with recurrent and multiple arterial thromboses",
abstract = "Acute intestinal ischemic disorders are potentially life threatening, making early diagnosis and emergency surgery crucial. Although hypercoagulability may induce mesenteric venous thrombosis, its association with mesenteric arterial thromboembolism remains controversial. We present the case of a 52-year-old man with hypercoagulability-induced acute arterial occlusive mesenteric ischemia. The patient suffered from arterial occlusive mesenteric ischemia, recent ischemic stroke, and previous renal infarction. He had no history of atrial fibrillation, atherosclerosis, vascular diseases, autoimmune diseases, malignancy, liver diseases, copper deficiency, or other risk factors for arterial thromboembolism. Segmental resection of the gangrenous bowel with primary end-to-end anastomosis was performed. A pathological examination revealed multiple thrombi within the mesenteric arteries of the infarcted bowel without apparent atherosclerosis of the vessels. The plasma level of factor VIII was high even 64 months postoperatively, which may have contributed to the recurrent and multiple arterial thromboses. A lifelong oral anticoagulation therapy was suggested. From our experience, we recommend that thrombophilia screening be performed in patients with acute intestinal ischemic disorders, particularly in those with a history of recurrent or multiple thromboembolism. Anticoagulant therapy should be prescribed for those with hypercoagulability.",
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N2 - Acute intestinal ischemic disorders are potentially life threatening, making early diagnosis and emergency surgery crucial. Although hypercoagulability may induce mesenteric venous thrombosis, its association with mesenteric arterial thromboembolism remains controversial. We present the case of a 52-year-old man with hypercoagulability-induced acute arterial occlusive mesenteric ischemia. The patient suffered from arterial occlusive mesenteric ischemia, recent ischemic stroke, and previous renal infarction. He had no history of atrial fibrillation, atherosclerosis, vascular diseases, autoimmune diseases, malignancy, liver diseases, copper deficiency, or other risk factors for arterial thromboembolism. Segmental resection of the gangrenous bowel with primary end-to-end anastomosis was performed. A pathological examination revealed multiple thrombi within the mesenteric arteries of the infarcted bowel without apparent atherosclerosis of the vessels. The plasma level of factor VIII was high even 64 months postoperatively, which may have contributed to the recurrent and multiple arterial thromboses. A lifelong oral anticoagulation therapy was suggested. From our experience, we recommend that thrombophilia screening be performed in patients with acute intestinal ischemic disorders, particularly in those with a history of recurrent or multiple thromboembolism. Anticoagulant therapy should be prescribed for those with hypercoagulability.

AB - Acute intestinal ischemic disorders are potentially life threatening, making early diagnosis and emergency surgery crucial. Although hypercoagulability may induce mesenteric venous thrombosis, its association with mesenteric arterial thromboembolism remains controversial. We present the case of a 52-year-old man with hypercoagulability-induced acute arterial occlusive mesenteric ischemia. The patient suffered from arterial occlusive mesenteric ischemia, recent ischemic stroke, and previous renal infarction. He had no history of atrial fibrillation, atherosclerosis, vascular diseases, autoimmune diseases, malignancy, liver diseases, copper deficiency, or other risk factors for arterial thromboembolism. Segmental resection of the gangrenous bowel with primary end-to-end anastomosis was performed. A pathological examination revealed multiple thrombi within the mesenteric arteries of the infarcted bowel without apparent atherosclerosis of the vessels. The plasma level of factor VIII was high even 64 months postoperatively, which may have contributed to the recurrent and multiple arterial thromboses. A lifelong oral anticoagulation therapy was suggested. From our experience, we recommend that thrombophilia screening be performed in patients with acute intestinal ischemic disorders, particularly in those with a history of recurrent or multiple thromboembolism. Anticoagulant therapy should be prescribed for those with hypercoagulability.

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