title: Clinical presentations, risk factors, treatment and outcomes in patients with splanchnic vein thrombosis: a single-center experience.
abstract: Splanchnic vein thrombosis (SVT) is an uncommon form of venous thrombosis. Management can be challenging due to underlying conditions, increased bleeding risk, and lack of evidence from clinical trials. We sought to characterize the presentation and management of patients with SVT at a large tertiary hospital. A total of 43 patients' electronic medical records were reviewed. Median age at diagnosis was 43 (18-71). Sixteen patients had isolated portal vein thrombosis (37.2 %), and 16 (37.2 %) had thrombosis involving multiple splanchnic veins. Abdominal pain was the most common clinical presentation (67.4 %). Thrombophilia was present in 18 patients (41.9 %), nine had underlying liver disease (20.9 %) and seven had inflammatory bowel disease (16.3 %). Thirty-nine (90.7 %) patients were treated with anticoagulation, and 11(25.6 %) of these patients underwent interventional procedures. Thirty (69.8 %) patients remained on indefinite anticoagulation. Results of follow-up imaging at least 1 month after diagnosis were available for 29 patients; imaging showed chronic, stable thrombosis in 14 patients (48.3 %), resolution of thrombosis in 13 patients (44.8 %) and asymptomatic progression in two patients (6.9 %). Recurrent thrombosis occurred in four patients (9.3 %). Major bleeding occurred in eight patients who received anticoagulation (18.6 %), including fatal subdural hematoma in one patient. In this cohort of patients managed by hematologists and gastroenterologists, the majority of patients were treated with anticoagulation. Interventional procedures were higher than in previously reported series. Our study strongly supports the interdisciplinary management of splanchnic venous thrombosis.
authors.affiliation: Division of Hematology and Medical Oncology, Weill-Cornell Medical College, 1305 York Avenue 7th Floor, New York, NY, 10021, USA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Klute
authors.affiliation: Weill-Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA.
authors.forename: Ersilia M
authors.initials: EM
authors.lastname: DeFilippis
authors.affiliation: Weill-Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA.
authors.forename: Kelissa
authors.initials: K
authors.lastname: Shillingford
authors.affiliation: Division of Hematology and Medical Oncology, Weill-Cornell Medical College, 1305 York Avenue 7th Floor, New York, NY, 10021, USA.
authors.forename: John
authors.initials: J
authors.lastname: Chapin
authors.affiliation: Division of Hematology and Medical Oncology, Weill-Cornell Medical College, 1305 York Avenue 7th Floor, New York, NY, 10021, USA. mtd2002@med.cornell.edu.
authors.forename: Maria T
authors.initials: MT
authors.lastname: DeSancho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013152:Splanchnic Circulation; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Outcome; Registries; Splanchnic circulation; Venous thrombosis
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