Division of General Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.
J Gastrointest Surg. 2012 Jun;16(6):1199-203. doi: 10.1007/s11605-012-1854-1. Epub 2012 Mar 29.
Patients with inflammatory bowel disease, such as Crohn's disease (CD), suffer from a threefold increase in the risk of venous thromboembolism. Small bowel, segmental bowel, or ileocolonic resection to treat Crohn's disease can lead to rare complications of portal vein thrombosis (PVT), which can lead to further poor health outcomes, such as small bowel ischemia. The study attempts to find different risk factors that may be associated with postoperative complications of PVT in Crohn's disease patients.
In a 1 to 3 case-control study following Institutional Review Board approval, 13 Crohn's disease patients with documented radiological postoperative diagnosis of PVT from 2004 to 2011 and 39 CD patients who did not have postoperative PVT were matched by retrospective chart review for patient demographics, preoperative course and workup, anticoagulant use, and operative procedure. Univariate analysis was performed to draw correlations on risk factors for the development of PVT.
In the 13 CD patients with PVT, concurrent cancer, liver disease, and dyslipidemia were present in 23.1%, 23.1%, and 15.4% of the population, respectively. Compared to the 39 CD only patients, concurrent cancer, liver disease, and dyslipidemia were present in only 2.6%, 2.6%, and 0% of the population, respectively. Of the CD patients with PVT, 61.5% were on preoperative steroids compared to 28.9% of the CD only patients. PVT development in CD patients is correlated with concurrent cancer (p = 0.016), liver disease (p = 0.016), dyslipidemia (p = 0.012), and preoperative steroid usage (p = 0.036).
Concurrent cancer, liver disease, dyslipidemia, and preoperative steroid usage were risk factors associated with the development of PVT in Crohn's patients. Since there is limited literature on PVT in CD, more data needs to be collected, and additional studies should be done to further assess the prevention, diagnosis, and management of the disease.
炎症性肠病（例如克罗恩病）患者的静脉血栓栓塞风险增加三倍。为治疗克罗恩病而进行的小肠、节段性肠或回结肠切除术可能导致门静脉血栓形成（PVT）的罕见并发症，这可能导致进一步的健康状况恶化，例如小肠缺血。本研究试图寻找可能与克罗恩病患者术后 PVT 并发症相关的不同危险因素。
在获得机构审查委员会批准的 1 至 3 例病例对照研究中，通过回顾性病历回顾，对 2004 年至 2011 年间有影像学术后诊断 PVT 的 13 例克罗恩病患者和 39 例无术后 PVT 的 CD 患者进行了病例对照研究，以匹配患者的人口统计学、术前病程和检查、抗凝药物使用和手术程序。进行单变量分析以绘制 PVT 发展的危险因素相关的相关性。
在 13 例 PVT 的 CD 患者中，同时患有癌症、肝病和血脂异常的患者分别占 23.1%、23.1%和 15.4%。与仅 39 例 CD 的患者相比，同时患有癌症、肝病和血脂异常的患者分别仅占 2.6%、2.6%和 0%。在患有 PVT 的 CD 患者中，61.5%的患者在术前使用了类固醇，而仅患有 CD 的患者中只有 28.9%的患者使用了类固醇。CD 患者的 PVT 发展与合并癌症（p=0.016）、肝病（p=0.016）、血脂异常（p=0.012）和术前类固醇使用（p=0.036）相关。
合并癌症、肝病、血脂异常和术前类固醇使用是与克罗恩病患者 PVT 发展相关的危险因素。由于关于 CD 患者的 PVT 的文献有限，因此需要收集更多数据，并进行更多研究以进一步评估疾病的预防、诊断和管理。
