title: Splanchnic vein thrombosis in severe acute pancreatitis: a 2-year, single-institution experience.
abstract: OBJECTIVE
  This study aimed to determine current practice in the management and outcome of splanchnic vein thrombosis complicating acute pancreatitis (AP).
  
  
  METHODS
  An audit of prospectively collected data for all patients presenting with AP was conducted. Patients with splanchnic vein thrombosis were grouped according to vessel involvement and whether or not systemic anticoagulation was administered.
  
  
  RESULTS
  Of 127 consecutive patients admitted with AP, 20 had splanchnic venous thrombosis; in all cases the thrombosis was associated with a severe attack of AP. Involvement of the splenic vein (SV), portal vein (PV) and superior mesenteric vein (SMV) was observed in 14, 10 and three patients, respectively. Involvement of more than one vessel was observed in six patients (SV and PV in four patients; SMV and SV in one patient; all three veins in one patient). Thromboses were colocalized with collections in 19 patients. Only four patients received systemic anticoagulation. Resolution of thrombosis was observed in six patients over a median of 77 days. No significant differences were observed in recanalization rates following anticoagulation (P= 0.076). No complications associated with systemic anticoagulation occurred. One patient developed liver failure associated with progressive PV thrombosis and one patient died.
  
  
  CONCLUSIONS
  Splanchnic vein thrombosis is a relatively common observation in severe AP and is associated with pancreatic necrosis and peripancreatic collections. Recanalization is observed in almost a third of patients, irrespective of whether or not they receive systemic anticoagulation.
authors.affiliation: Centre for Hepatopancreatobiliary Surgery and Liver Transplantation, Royal Free Hospital, London, UK.
authors.forename: Hector Jazmin
authors.initials: HJ
authors.lastname: Gonzelez
authors.forename: Samir J
authors.initials: SJ
authors.lastname: Sahay
authors.forename: Benny
authors.initials: B
authors.lastname: Samadi
authors.forename: Brian Ritchie
authors.initials: BR
authors.lastname: Davidson
authors.forename: Sakhawat Hussain
authors.initials: SH
authors.lastname: Rahman
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008131:London; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D011169:Portal Vein; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013162:Splenic Vein; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality
chemical_list: D000925:Anticoagulants
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