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Testinal symptoms of nausea, vomiting, diarrhoea, and constipation as well as a general feeling of malaise. Classification of the causes of mesenteric venous thrombosis is made on a primary, idiopathic, or secondary basis. Primary and idiopathic causes, such as splanchnic venous thrombosis are relatively rare at 15-20% and are not associated with predisposing conditions.13 Secondary causes represent 80% of all cases, the most common of which are pancreatitis, history of deep vein thrombosis, inflammation after abdominal surgery, and neoplasm.3 The oral contraceptive has been identified as causing 9-18% of cases in young women.1 Diagnosing mesenteric venous thrombosis requires a high index of suspicion and the use of investigative imaging. Prognosis depends on early diagnosis and effective treatment with anticoagulation and surgical resection of necrosed bowel and the minimisation of recurrence by lifelong management if the patient's medical history carries a high risk of further thrombosis. In this case the diagnosis was missed the first time, and this is often the case with mesenteric venous thrombosis. Fortunately, this patient was diagnosed before the ischaemia led to necrosis of the bowel and to a much worse prognosis. Patients that need surgical resection of the necrosed bowel have more complicated prognoses, with the possibility of, because prevacid.

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Common risk factors associated with the development of bisphosphonate-associated ONJ include: History of taking bisphosphonates, especially IV formulations. The concurrent use of steroids appears to contribute to this risk. Previous history of cancer e.g., multiple myeloma or metastatic disease to bone ; , osteoporosis, Paget's disease or other indications for bisphosphonate treatment. A history of a traumatic dental procedure. Most case reports occur after a tooth extraction, although other traumatic dental procedures may also be associated with the occurrence of ONJ. One case report describes bisphosphonate-associated ONJ occurring 6 months after placement of five dental implants with the subsequent loss of all implants Starck and Epker 1995 ; . Several reports indicate the spontaneous development of bisphosphonate-associated ONJ without a prior traumatic dental procedure. A question exists as to whether bisphosphoante-associated ONJ is a drug effect i.e., observed with only a few bisphosphonates ; or a class effect i.e., may occur with all bisphosphonates with the incidence varying according to potency or other factors ; . To date, the majority of reports have described ONJ occurring in patients taking I.V. bisphosphonates e.g., zolendronate [Zometa ], or pamidronate [Aredia ] ; . However, in several publications, oral bisphosphonates have been associated with the development of ONJ Starck and Epker 1995; Carter and Goss 2003; Marx 2003; Chang 2004; Ruggiero and Mehrotra 2004; Migliorati et al. 2005; Purcell and Boyd 2005 ; . In addition, a recent FDA ODS Postmarketing Safety Review stated that bisphosphonate-associated ONJ "may be a class effect" Chang 2004 ; . Recently revised product packages for oral bisphosphonate medications e.g., alendronate [Fosamax ] and risedrontae [Actonel ] now describe a risk for bisphosphonate-associated ONJ Merck 2005; P&G 2005 ; . Therefore, until further information is available, it would appear prudent to consider all patients taking bisphosphonates to be at some risk for ONJ, with the recognition that the magnitude of the risk probably varies depending upon the particular bisphosphonate taken, patient factors e.g., concurrent drugs, diseases, etc. ; , and dental treatment history. The information at this time suggests that patients taking IV bisphosphonates have a higher risk for developing ONJ, while patients taking oral bisphosphonates have a lower risk and glyburide.
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