title: Prognostic factors in noncirrhotic patients with splanchnic vein thromboses.
abstract: OBJECTIVE
  Splanchnic vein thrombosis (SVT), not associated with cancer or liver cirrhosis, is a rare event and scanty data are available on its natural history, long-term prognosis, and treatment. In this study 121 SVT patients consecutively seen from January 1998 to December 2005 were included and 95 of them were followed up for a median time of 41 months. Screening for thrombophilic factors was performed in 104 patients. New thrombotic or bleeding episodes were registered and anticoagulant therapy was performed according to preestablished criteria.
  
  
  RESULTS
  SVT was an incidental finding in 34 (28.1%) patients; 34 (28.1%) presented with abdominal infarction; 39 (32.2%) had bowel ischemia or acute portal vein thrombosis; 14 (11.6%) had bleeding from portal hypertensive sources. Survival rates at 1, 3, and 7 yr were 95%, 93.3%, and 89.6%, respectively; 87.5% of deaths occurred at onset of SVT as complications of intestinal infarction. Patients with isolated portal vein thromboses had symptoms and intestinal infarction in 16/41 (39%) and 0/41 (0%) of the cases, respectively, whereas superior mesenteric vein thromboses, isolated or not, were associated with symptoms and intestinal infarction in 69/75 (92%) and 34/75 (45%), respectively. During the follow-up 14 (14.7%) suffered from 39 episodes of gastrointestinal bleeding with no deaths. A previous gastrointestinal bleed was associated with new hemorrhagic events during follow-up. New venous thrombotic episodes occurred in 10 of 95 patients (10.5%), of which 73% were in the splanchnic area. Seven out of these 10 patients had a chronic myeloproliferative disease (MPD) and none was on anticoagulation.
  
  
  CONCLUSIONS
  Anticoagulant therapy was effective to obtain recanalization of acute SVT in 45.4% of patients and preserved patients from recurrent thrombosis when given lifelong.
authors.affiliation: Gastroenterologia, A. Cardarelli Hospital, Naples, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Amitrano
authors.forename: Maria Anna
authors.initials: MA
authors.lastname: Guardascione
authors.forename: Mariano
authors.initials: M
authors.lastname: Scaglione
authors.forename: Luca
authors.initials: L
authors.lastname: Pezzullo
authors.forename: Nicola
authors.initials: N
authors.lastname: Sangiuliano
authors.forename: Mariano F
authors.initials: MF
authors.lastname: Armellino
authors.forename: Francesco
authors.initials: F
authors.lastname: Manguso
authors.forename: Maurizio
authors.initials: M
authors.lastname: Margaglione
authors.forename: Paul R J
authors.initials: PR
authors.lastname: Ames
authors.forename: Luigi
authors.initials: L
authors.lastname: Iannaccone
authors.forename: Elvira
authors.initials: E
authors.lastname: Grandone
authors.forename: Luigia
authors.initials: L
authors.lastname: Romano
authors.forename: Antonio
authors.initials: A
authors.lastname: Balzano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012307:Risk Factors; D013152:Splanchnic Circulation; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy