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Journal of Thrombosis and Thrombolysis

, Volume 42, Issue 2, pp 267–271 | Cite as

Clinical presentations, risk factors, treatment and outcomes in patients with splanchnic vein thrombosis: a single-center experience

  • Kelsey Klute
  • Ersilia M. DeFilippis
  • Kelissa Shillingford
  • John Chapin
  • Maria T. DeSanchoEmail author
Article

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.

Keywords

Venous thrombosis Splanchnic circulation Registries Outcome 

Notes

Acknowledgments

We thank Dr. Stephen M. Pastores for his valuable suggestions to the manuscript.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kelsey Klute
    • 1
  • Ersilia M. DeFilippis
    • 2
  • Kelissa Shillingford
    • 2
  • John Chapin
    • 1
  • Maria T. DeSancho
    • 1
    Email author
  1. 1.Division of Hematology and Medical OncologyWeill-Cornell Medical CollegeNew YorkUSA
  2. 2.Weill-Cornell Medical CollegeNew YorkUSA

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