Objective: To study the diagnosis and management of acute primary superior mesenteric venous thrombosis （APSMVT）.
:Methods :The clinical records of 19 cases of APSMVT treated in our hospital in the recent 3 years were retrospectively analyzed.
:Results:Preoperative diagnosis of APSMVT was suspected in only 7 cases. All the cases received emergency operation and 3 cases had reoperation. Among them 17 cases were cured and 2 cases died. Seventeen cases were followed up for 0.5-4 y, and all of them were alive and in good health.
:Conclusions:The diagnosis of APSMVT lacks specificity. Doppler ultrasonography, CT and selective angiography are of great importance for early diagnosis. Total resection of necrotic intestines and appropriate anticoagulation after operation can decrease the mortality and recurrence rate.