Portomesenteric venous thrombosis: a community hospital experience with 103 consecutive patients.
BACKGROUND
Portomesenteric venous thrombosis (PMVT) is uncommon but associated with ischemic bowel and mortality.


OBJECTIVE
The purpose of this study was to determine the occurrence of PMVT in a community setting and evaluate current diagnosis, treatment, and outcomes.


METHODS
Medical records of consecutive patients admitted to a community-based hospital diagnosed with PMVT were reviewed. Patients were divided into 2 groups: those diagnosed from 1997 to 2003 and those diagnosed from 2004 to 2009.


RESULTS
One hundred three patients were included. The proportion of chronic PMVT diagnoses increased in the recent group (14% in contrast to 44%, P = .001). Treatment was more common in acute in contrast to chronic PMVTs (70% in contrast to 48%, P = .035). The median length of stay decreased over time (6 in contrast to 3 days, P = .004). Three patients underwent surgical intervention. Overall, 30-day mortality was 17% and did not change over time.


CONCLUSIONS
Diagnosis and treatment have changed with increased differentiation between acute and chronic PMVT; outcomes were similar. Surgical intervention was rarely necessary. Mortality is attributed to patient comorbidity rather than PMVT.
Department of Medical Education, Gundersen Lutheran Medical Foundation, La Crosse, WI, USA.
Mark N
MN
Abraham
Michelle A
MA
Mathiason
Kara J
KJ
Kallies
Thomas H
TH
Cogbill
Stephen B
SB
Shapiro
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D010690:Phlebography; D011169:Portal Vein; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014922:Wisconsin / Q000453:epidemiology; D055815:Young Adult
D005343:Fibrinolytic Agents