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Acute inferior mesenteric venous thrombosis in a child

Inferior mesenteric venous thrombosis is a very rare condition with serious management challenge, especially in a resource-poor environment. The acute variety is associated with high morbidity and mortality, especially if there are accompanying bowel infarction and peritonitis. The case of a 12-year-old boy was referred from a private hospital after a failed attempt at appendicectomy. The patient presented with features of generalized peritonitis and severe sepsis. Exploratory laparotomy after optimization showed massive hemorrhagic ascetic fluid, extensive left colonic gangrene extending from distal transverse colon to the sigmoid colon, and thrombosis in the branches of the inferior mesenteric vessel. The patient died 36 h postoperatively at the intensive care unit. A high index of suspicion and early bowel resection in cases of associated bowel infarction will improve outcome.