Abstract
BACKGROUND Women are at an increased risk of developing venous thrombosis during gestation and the postpartum period, due to physiological and anatomical changes. Superior mesenteric vein thrombosis (SMVT) is a rare and severe complication with a dangerous course and a high mortality rate. Heparin-induced thrombocytopenia (HIT) is also rare in patients treated with heparin and presents with thrombosis and thrombocytopenia. We report a patient with SMVT diagnosis who was treated with heparin anticoagulation after surgery and eventually developed HIT. CASE REPORT The patient was a 30-year-old woman with a diagnosis of SMVT 10 days after giving birth to her second child. She was treated with heparin anticoagulation and interventional catheter-based thrombolysis and thrombectomy, which was ineffective, and she showed peritonitis. We therefore performed an emergency laparotomy, during which we found partial small intestine necrosis and performed a partial small bowel resection. However, the systemic thrombosis worsened postoperatively, and after a multidisciplinary team consultation, HIT was diagnosed. After switching to non-heparin anticoagulation, the patient's condition improved, and she was discharged from the hospital. CONCLUSIONS This is the first case report of HIT secondary to heparin anticoagulation in a parturient who underwent surgery for intestinal necrosis caused by SMVT. Our case highlights the challenge of treating SMVT and the difficulty of diagnosis of HIT. SMVT is a serious condition that requires sufficient experience to judge the timing of surgery. HIT is a rare complication that occurs during heparin use, and its timely diagnosis and treatment have a significant impact on patient prognosis.