Mesenteric Venous Thrombosis Treatment Outcomes and Prognosis: Scoping Review with ☸️SAIMSARA

To synthesize current evidence regarding mesenteric venous thrombosis. The review uses 436 references and builds its evidence map from 1058 original studies with 159421 total participants/sample observations (topic-deduplicated ΣN). This scoping review suggests that mesenteric venous thrombosis is best approached as a high-risk yet increasingly treatable splanchnic thrombosis in which early cross-sectional imaging and prompt anticoagulation form the management core, with escalation reserved for threatened bowel. Anticoagulation, including both vitamin K antagonists and direct oral agents, was associated with favorable recanalization and low recurrence, and a medical-first policy was associated with reduced mortality from 39% to 11%. Outcomes appear more favorable than arterial mesenteric ischemia, though early mortality and progression to portal hypertensive sequelae remain clinically important. Because the evidence is dominated by case series and uncontrolled cohorts without randomized comparisons, these signals should be interpreted as descriptive patterns rather than confirmed effects. Future prospective comparative trials using standardized recanalization, bowel-preservation, and bleeding endpoints are needed to clarify optimal anticoagulant choice, duration, and the role of endovascular escalation.