Vascular surgery: mesenteric venous thrombosis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Vascular surgery: mesenteric venous thrombosis

Sample item

A 30-year-old woman on oral contraceptives has two days of worsening abdominal pain out of proportion to examination and a mildly raised lactate. Contrast CT shows a thrombosed superior mesenteric vein and thickened oedematous ileum, with no free air. What is the first treatment?

AImmediate systemic anticoagulation with heparinBEmergency thrombolysis via the arterial route onlyCImmediate small bowel resection for all patientsDAntiplatelet therapy with aspirin

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Immediate systemic anticoagulation with heparin

Mesenteric venous thrombosis is treated by prompt heparin, which prevents clot extension and bowel infarction. Laparotomy and resection are reserved for peritonitis or non-viable bowel.

Option by option

A. Immediate systemic anticoagulation with heparin (correct)
Correct. Heparin is the cornerstone of treatment for mesenteric venous thrombosis.
B. Emergency thrombolysis via the arterial route only
Arterial thrombolysis is for arterial occlusion.
C. Immediate small bowel resection for all patients
Resection is only needed if infarction or peritonitis develops.
D. Antiplatelet therapy with aspirin
Aspirin is not an adequate treatment for an established venous thrombus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Immediate systemic anticoagulation with heparin. Mesenteric venous thrombosis is treated by prompt heparin, which prevents clot extension and bowel infarction.

Why is "Emergency thrombolysis via the arterial route only" not the answer?

Arterial thrombolysis is for arterial occlusion.

Why is "Immediate small bowel resection for all patients" not the answer?

Resection is only needed if infarction or peritonitis develops.

Why is "Antiplatelet therapy with aspirin" not the answer?

Aspirin is not an adequate treatment for an established venous thrombus.

What concept does this question test?

It tests Vascular surgery: mesenteric venous thrombosis in General Surgery. Laparotomy and resection are reserved for peritonitis or non-viable bowel.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vascular surgery: mesenteric venous thrombosis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.