The clinical importance in differentiating portal from mesenteric venous thrombosis.
OBJECTIVE
To relate the extent of portomesenteric thrombosis to the risk of intestinal infarction, concomitant venous thromboembolism and underlying diseases.


METHODS
Identification of patients with mesenteric (MVT) and portal vein thrombosis (PVT) at Malmö University Hospital from a clinical series from 2000 - 2006 as well as an autopsy cohort of 24000 consecutive autopsies from 1970 - 1982.


RESULTS
In the clinical comparative study, MVT (n=51) was associated with more thrombophilic disorders (P=0.040) and intestinal infarctions (P=0.046), whereas patients with PVT without extension to the superior mesenteric vein (n=20) more often had liver disease (P<0.001). At autopsy, 270 patients with portomesenteric venous thrombosis were found; twenty-nine out of the 31 cases with MVT had intestinal infarction. None (0%) of the 239 patients with PVT without extension into the superior mesenteric vein had intestinal infarction. Portomesenteric venous thrombosis and intestinal infarction was associated with concomitant venous thromboembolism (O. R. 6.1 [95% CI 1.8-21]).


CONCLUSIONS
MVT carries a high risk of developing intestinal infarction and is associated with concomitant venous thromboembolism, whereas PVT is associated with liver disease.
Vascular Centre, Malmö University Hospital, Malmö, Sweden. Stefan.acosta@telia.com
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Acosta
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Alhadad
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Verbaan
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Ogren
D000328:Adult; D000368:Aged; D001344:Autopsy; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007238:Infarction / Q000453:epidemiology; D007422:Intestines / Q000098:blood supply; D008107:Liver Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D011169:Portal Vein; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000453:epidemiology