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Acute mesenteric venous thrombosis — SCE Acute Medicine MCQ

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ModerateAcute GI PresentationsAcute mesenteric venous thrombosisSCE Acute Medicine

A 50-year-old man is assessed on the acute medical unit. He has abdominal pain, diarrhoea and mild peritonism. CT shows thrombus in the superior mesenteric vein and bowel wall oedema. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Mesenteric venous thrombosis

Mesenteric venous thrombosis is the best answer because venous thrombosis with bowel-wall oedema and abdominal pain indicates mesenteric venous thrombosis. Acute mesenteric venous thrombosis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Consider thrombophilia and local inflammatory triggers after stabilisation.

Reference: https://b-s-h.org.uk/guidelines#acute-medicine-order-57-1