Splanchnic vein thrombosis in acute pancreatitis: a review of treatment indications, methods, and outcomes in a single institution

被引:7
作者
Wilson, Tamalee M. [1 ]
Daneshmand, Ali [1 ]
Parys, Simon [2 ]
Watanabe, Yuki [1 ]
机构
[1] Royal Perth Hosp WA, Gen Surg Unit, GPO Box X2213, Perth, WA 6847, Australia
[2] Armadale Hlth Serv WA, Gen Surg Unit, Perth, WA, Australia
关键词
pancreatitis; splanchnic vein thrombosis; systemic therapeutic anticoagulation; VENOUS THROMBOSIS; ANTICOAGULATION;
D O I
10.1111/ans.18442
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundSplanchnic vein thrombosis (SVT) is a well-recognized complication of acute pancreatitis. The question of whether or not to treat SVT with systemic therapeutic anticoagulation (STA) remains to be seen. The universal use of anticoagulation may lead to an increased risk of bleeding complications associated with acute pancreatitis. Literature on this subject is sparse and there is no clear guideline on how to treat SVT. Our research demonstrates local practice where therapeutic anticoagulation in SVT varies. MethodsA retrospective review of patients presenting with acute pancreatitis admitted over a five-year period to a single tertiary hospital with splanchnic vein thrombosis was performed. ResultsOf the 1408 patients admitted with acute pancreatitis, 42 were diagnosed with splanchnic vein thrombosis, with a male dominance of 34 (81%). A total of 25 patients received anticoagulation. The use of anticoagulation was dependent on the location of the thrombus, P < 0.01. Anticoagulation use was most common in cases of combination mesenteric, splenic, and portal vein thrombus (100%), isolated mesenteric vein (100%), isolated portal vein (89%), combination portal and splenic vein (87%), and combination mesenteric and splenic vein (75%). The rate of anticoagulation use was lowest in isolated splenic vein thrombus (23%). ConclusionThe early commencement of STA in patients with acute pancreatitis and triple-vessel SVT or with portal vein involvement is supported by our data. Isolated splenic vein thrombus does not require systemic therapy. Further research is needed to establish a clear clinical guideline.
引用
收藏
页码:2487 / 2491
页数:5
相关论文
共 16 条
[1]   Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus [J].
Banks, Peter A. ;
Bollen, Thomas L. ;
Dervenis, Christos ;
Gooszen, Hein G. ;
Johnson, Colin D. ;
Sarr, Michael G. ;
Tsiotos, Gregory G. ;
Vege, Santhi Swaroop .
GUT, 2013, 62 (01) :102-111
[2]   Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding [J].
Butler, James R. ;
Eckert, George J. ;
Zyromski, Nicholas J. ;
Leonardi, Michael J. ;
Lillemoe, Keith D. ;
Howard, Thomas J. .
HPB, 2011, 13 (12) :839-845
[3]   Anticoagulant therapy for splanchnic vein thrombosis ISTH SSC Subcommittee Control of Anticoagulation [J].
Di Nisio, Marcello ;
Valeriani, Emanuele ;
Riva, Nicoletta ;
Schulman, Sam ;
Beyer-Westendorf, Jan ;
Ageno, Walter .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2020, 18 (07) :1562-1568
[4]   Portosplenomesenteric Venous Thrombosis in Patients With Acute Pancreatitis Is Associated With Pancreatic Necrosis and Usually Has a Benign Course [J].
Easler, Jeffrey ;
Muddana, Venkata ;
Furlan, Alessandro ;
Dasyam, Anil ;
Vipperla, Kishore ;
Slivka, Adam ;
Whitcomb, David C. ;
Papachristou, Georgios I. ;
Yadav, Dhiraj .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2014, 12 (05) :854-862
[5]   Splanchnic vein thrombosis in severe acute pancreatitis: a 2-year, single-institution experience [J].
Gonzelez, Hector Jazmin ;
Sahay, Samir J. ;
Samadi, Benny ;
Davidson, Brian Ritchie ;
Rahman, Sakhawat Hussain .
HPB, 2011, 13 (12) :860-864
[6]  
Hajibandeh S., 2021, PANCREAS, V49, P84
[7]   Management of Acute Non-cirrhotic and Non-malignant Portal Vein Thrombosis: A Systematic Review [J].
Hall, T. C. ;
Garcea, G. ;
Metcalfe, M. ;
Bilku, D. ;
Dennison, A. R. .
WORLD JOURNAL OF SURGERY, 2011, 35 (11) :2510-2520
[8]  
Harris S, 2013, PANCREAS, V42, P1251, DOI 10.1097/MPA.0b013e3182968ff5
[9]   Splanchnic Venous Thrombosis in Acute Pancreatitis: Does Anticoagulation Affect Outcome? [J].
Junare, Armeshwar Ramesh ;
Udgirkar, Suhas ;
Nair, Sujit ;
Debnath, Prasanta ;
Jain, Shubham ;
Modi, Ammar ;
Rathi, Pravin ;
Rane, Siddhesh ;
Contractor, Qais .
GASTROENTEROLOGY RESEARCH, 2020, 13 (01) :25-31
[10]   Splanchnic Venous Thrombosis and Pancreatitis [J].
Nadkarni, Nikhil A. ;
Khanna, Sahil ;
Vege, Santhi Swaroop .
PANCREAS, 2013, 42 (06) :924-931