Akuter hämorrhagischer Jejunuminfarkt als Erstmanifestation einer APC-Resistenz bei Faktor-V-Leiden-Mutation - ein Fallbericht

Zusammenfassung

Berichtet wird über einen 43-jährigen Patienten, der sich wegen akuter abdomineller Schmerzen in der Rettungsstelle vorstellte. Als Ursache fand sich eine hämorrhagische Dünndarminfarzierung bei Pfortader- und Mesenterialvenenthrombose zunächst unklarer Ursache. Die weitere Diagnostik erbrachte trotz fehlender anamnestischer Hinweise für eine familiäre thrombophile Prädisposition eine heterozygote Faktor-V-Leiden-Mutation. Diagnostik, Therapie und klinischer Verlauf werden beschrieben. Außerdem wird ein Überblick über das Krankheitsbild der akuten mesenterialvenösen Durchblutungsstörung unter besonderer Berücksichtigung genetisch determinierter Thrombophilien gegeben.

Abstract

We report on a 43-year-old patient presenting to the emergency department with acute abdominal pain the source of which turned out to be acute hemorrhagic jejunal infarction due to portal and mesenteric vein occlusion with no apparent cause. In spite of a lacking history of hereditary thrombophilic risk factors, further diagnostic procedures revealed heterozygous factor V Leiden mutation. Diagnosis, therapy and clinical course are described. An overview on acute mesenteric venous occlusion with special reference to genetically determined thrombophilic disorders is given.

Schlüsselwörter

mesenterialvenöse Durchblutungsstörung - hämorrhagischer Dünndarminfarkt - Faktor-V-Leiden - APC-Resistenz

Key words

mesenteric vein occlusion - hemorrhagic jejunal infarction - factor V Leiden mutation - APC-resistance

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