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Portal Vein Thrombi After Restorative Proctocolectomy: Serious Complication Without Long-Term Sequelae

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Diseases of the Colon & Rectum

Purpose

Portal vein thrombi have been observed after restorative proctocolectomy and ileal pouch-anal anastomosis, and present as a clinical spectrum of abdominal pain, fever, and leukocytosis. Anticoagulation treatment is usually associated with resolution of symptoms. However, the long-term consequences and effect on pouch function are not known. The purpose of this study was to analyze the long-term functional outcome of patients with confirmed portal vein thrombi after restorative proctocolectomy.

Methods

A retrospective study of all patients undergoing restorative proctocolectomy from January 1997 to 2000 was performed. A case-control study was designed that matched 37 patients with confirmed portal vein thrombi in this period with 133 patients without portal vein thrombi; the groups were compared with respect to pouch function and quality of life by using the Global Cleveland Clinic Quality of Life Questionnaire for pelvic pouch patients.

Results

The mean follow-up was 4.73 (range, 4.21–7.28) years. The percentage of male patients was 58.8. The most common diagnosis was ulcerative colitis (62.4 percent). There were no significant differences between portal vein thrombi patients and controls with respect to pouch function (number of bowel movements, urgency, incontinence), episodes of pouchitis, or quality of life.

Conclusions

Portal vein thrombi can be a serious complication after restorative proctocolectomy that usually resolves with anticoagulation therapy. Long-term pouch function and quality of life are not affected.

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Authors and Affiliations

  1. Colorectal Surgery Unit, Department of Surgery, Bellvitge University Hospital, L’ Hospitalet de Llobregat, Barcelona, Spain

    M. Millan M.D.

  2. Center for Inflammatory Bowel Disease, Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, 44195

    T. L. Hull M.D. & F. Remzi M.D.

  3. Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio

    J. Hammel M.S.

Authors
  1. M. Millan M.D.
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  2. T. L. Hull M.D.
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  3. J. Hammel M.S.
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  4. F. Remzi M.D.
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Corresponding author

Correspondence to T. L. Hull M.D..

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Millan, M., Hull, T.L., Hammel, J. et al. Portal Vein Thrombi After Restorative Proctocolectomy: Serious Complication Without Long-Term Sequelae. Dis Colon Rectum 50, 1540–1544 (2007). https://doi.org/10.1007/s10350-007-0297-3

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  • DOI: https://doi.org/10.1007/s10350-007-0297-3

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