Ertuğrul Ibrahim, Köklü Seyfettin, Başar Omer, Yüksel Osman, Uçar Engin, Coban Sahin, Ibiş Mehmet, Arhan Mehmet, Odemiş Bülent, Saşmaz Nurgül
Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
J Clin Gastroenterol. 2008 Aug;42(7):835-8. doi: 10.1097/MCG.0b013e318046eadc.
Thrombosis in the portal system causes a wide spectrum of clinical pictures. There are few published studies describing the clinical features and consequences of portal venous system thrombosis. We aimed to document presentations and outcomes in patients with thrombosis in the portal and/or splenic veins.
The study included 95 patients who were diagnosed with portal venous system thrombosis in the period September 2001 to April 2006. Demographics, clinical presentation, diagnostic investigation, management, morbidity, and mortality were recorded in their follow-up.
Of the 95 patients with portal vein thrombosis (PVT), 35 had isolated PVT (IPVT), 27 had isolated splenic vein thrombosis (ISVT), and 33 had thrombosis in both the portal and splenic veins (PSVT). The mean follow-up periods after diagnosis of IPVT, ISVT, and PSVT were 36, 31, and 32 months, respectively. Abdominal pain and gastrointestinal bleeding were the most common symptoms at presentation in the IPVT and PSVT groups, whereas abdominal pain was the dominant symptom in the ISVT group. During the follow-up period, no bleeding was seen in 26 of the 35 (74%) patients with IPVT, in 23 of the 33 (70%) patients with PSVT, and in 24 of the 27 (89%) patients with ISVT. Biliopathy developed during follow-up in 11 of 35 patients with IPVT, in 1 of 27 with ISVT, and in 5 of 33 with PSVT. In the ISVT group, there were 11 deaths, and one each in the IPVT and PSVT groups.
The etiology of PVT varies in portal and splenic veins. IPVT has a higher morbidity (bleeding and portal biliopathy), whereas ISVT that is not associated with an underlying malignancy has a favorable prognosis.
门静脉系统血栓形成会引发一系列广泛的临床症状。关于门静脉系统血栓形成的临床特征及后果的已发表研究较少。我们旨在记录门静脉和/或脾静脉血栓形成患者的临床表现及预后情况。
本研究纳入了95例在2001年9月至2006年4月期间被诊断为门静脉系统血栓形成的患者。在随访过程中记录了患者的人口统计学信息、临床表现、诊断检查、治疗、发病率及死亡率。
95例门静脉血栓形成（PVT）患者中，35例为孤立性门静脉血栓形成（IPVT），27例为孤立性脾静脉血栓形成（ISVT），33例为门静脉和脾静脉均有血栓形成（PSVT）。IPVT、ISVT和PSVT诊断后的平均随访时间分别为36个月、31个月和32个月。IPVT组和PSVT组最常见的首发症状是腹痛和胃肠道出血，而腹痛是ISVT组的主要症状。在随访期间，35例IPVT患者中有26例（74%）未出现出血，33例PSVT患者中有23例（70%）未出现出血，27例ISVT患者中有24例（89%）未出现出血。随访期间，35例IPVT患者中有11例出现胆汁淤积症，27例ISVT患者中有1例出现胆汁淤积症，33例PSVT患者中有5例出现胆汁淤积症。ISVT组有11例死亡，IPVT组和PSVT组各有1例死亡。
门静脉和脾静脉中PVT的病因各不相同。IPVT的发病率较高（出血和门静脉胆汁淤积症），而与潜在恶性肿瘤无关的ISVT预后良好。
