Portal vein thrombosis: prevalence, patient characteristics and lifetime risk: a population study based on 23,796 consecutive autopsies.
OBJECTIVE
To assess the lifetime cumulative incidence of portal venous thrombosis (PVT) in the general population.


METHODS
Between 1970 and 1982, 23,796 autopsies, representing 84% of all in-hospital deaths in the Malmö city population, were performed, using a standardised protocol including examination of the portal vein. PVT patients were characterised and the PVT prevalence at autopsy, an expression of life-time cumulative incidence, assessed in high-risk disease categories and expressed in terms of odds ratios and 95% CI.


RESULTS
The population prevalence of PVT was 1.0%. Of the 254 patients with PVT 28% had cirrhosis, 23% primary and 44% secondary hepatobiliary malignancy, 10% major abdominal infectious or inflammatory disease and 3% had a myeloproliferative disorder. Patients with both cirrhosis and hepatic carcinoma had the highest PVT risk, OR 17.1 (95% CI 11.1-26.4). In 14% no cause was found; only a minority of them had developed portal-hypertension-related complications.


CONCLUSIONS
In this population-based study, PVT was found to be more common than indicated by previous clinical series. The markedly excess risk in cirrhosis and hepatic carcinoma should warrant an increased awareness in these patients for whom prospective studies of directed intervention might be considered.
Ogren
Mats
M
Department of Vascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. mats.ogren@astrazeneca.com
Bergqvist
David
D
Björck
Martin
M
Acosta
Stefan
S
Eriksson
Henry
H
Sternby
Nils H
NH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D015995:Prevalence; D020246:Venous Thrombosis / Q000150:complications / Q000453:epidemiology* / Q000209:etiology