The Predictor Factors of Portal Vein Thrombosis in Pancreatitis Patients

Abstract

Introduction: Portal vein thrombosis(PVT) is partial or complete occlusion of the portal vein. The most common causes of PVT are cancers, cirrhosis or/and severe inflammatory processes like pancreatitis. Our aim in this study is to determine the predicator factors that associated with the development of PVT in pancreatitis patients. Other objective of the study is to assess the recanalization rate after treating with the anticoagulation. Methods: A single center, retrospective chart review and analysis of patients with pancreatitis who had PVT between the age of 18 and 80 who were admitted to our institute between 2006 and January 2016. PVT diagnosis was confirmed by CT scans, MRI or ultrasound Doppler and been followed by images 3-6 months later to confirm the resolution or the extension of the thrombus. Results: Eighty patients with PVT-related pancreatitis were initially screened, 47 were excluded secondary to the presence of cirrhosis, cancers or lost in the follow up. A total of 33 patients, 24 acute and 9 chronic pancreatitis, were included in our cohort. The mean age of the cohort is 59 +/-16. Males represented 55% of the cohort and 45 % were females. Caucasian race represented 90% of the cohort. Seventeen patients (51%) had complications with the pancreatitis (fluid collections, pseudocyst or wall-off necrosis). Complete occlusion of the portal vein was found in 57.5% of the cohort while partial occlusion was found in 42.5%. Acute PVT was found in 89% of the cohort. Table 1 20(60%) patients received anticoagulation therapy, 5 patients had resolution of the PVT and 8 patients had an extension of the thrombus. 13(40%) patients did not receive treatment, 4 patients had resolution of the PVT and 5 had an extension of the thrombus. No deference was found between the group who treated with anticoagulation in terms PVT resolution or extension when compared to the non- treated group.Table 1Conclusion: Pancreatitis-related portal vein thrombosis is associated with acute and complicated forms of pancreatitis. Treatment with anticoagulation does not increase the chances of PVT resolution or prevention of the thrombus extension.Table 2