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  • Title: Risk factors influencing the outcome of portal and mesenteric vein thrombosis.
    Author: Berney T, Morales M, Broquet PE, Mentha G, Morel P.
    Journal: Hepatogastroenterology; 1998; 45(24):2275-81. PubMed ID: 9951910.
    Abstract:
    BACKGROUND/AIMS: This study analyzes risk factors that influence the course and outcome of portal and superior mesenteric vein thrombosis (PMVT). METHODOLOGY: We retrospectively reviewed 45 patients who were admitted to our institution over a 17-year period with a diagnosis of PMVT. Patients were classified according to three etiological groups, namely: cirrhosis (47%), pancreatitis (22%), and other causes (33%), with 1 patient belonging to two different groups. RESULTS: Over the course of the disease, rupture of gastric or esophageal varices was more frequent (p<0.005) in cirrhotics (75%) than non-cirrhotics (17%). Sclerotherapy was always the first treatment for variceal bleeding, with a success rate of 73% but a rate of recurrence of 56%. Surgical procedures were performed on 22% of patients. Actuarial survival was 43% at 5 years, but survival was significantly increased for idiopathic cases (p=0.005) and decreased in the presence of cirrhosis (p<0.001), malignancy (p<0.0001) or hematemesis (p<0.005). Gastrointestinal bleeding and terminal malignancies were responsible for 50% of deaths. CONCLUSIONS: Cirrhotic patients experience a detrimental outcome with an increased risk of gastrointestinal bleeding, which is the first cause of mortality in PMVT. Non-cirrhotic patients, especially idiopathic cases, enjoy a longer survival rate and seldom bleed, which allows for the use of anticoagulative therapy.
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