Department of Hepato-Gastroenterology, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France.
Inflamm Bowel Dis. 2013 Mar;19(3):582-9. doi: 10.1097/MIB.0b013e31827eea5f.
Inflammatory bowel disease (IBD) is associated with a high risk of deep venous thromboembolism. However, few data are available so far on portomesenteric vein thrombosis (PMVT). The aim of this study was to describe the characteristics of PMVT in patients with IBD.
A retrospective study was conducted at 13 GETAID (Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif) centers from January 1995 to June 2010. The following data were collected, using a standardized questionnaire: characteristics of IBD, disease status at the time of PMVT, PMVT characteristics and mode of discovery, concomitant prothrombotic disorders, anticoagulant therapy, and evolution of PMVT.
Fifty cases (29 men and 21 women; median age, 41 years) were identified, including 14 patients with ulcerative colitis and 36 with Crohn's disease. Thirty-one patients (62%) presented with acute PMVT. Twenty-four patients had previously undergone surgical treatment, and IBD was active in 23 cases (77%) of acute thrombosis. The discovery of PMVT was fortuitous in 40% of our cases. Among the 43 patients screened for a prothrombotic disorder, abnormalities were observed in 17 patients (40%) (mainly hyperhomocysteinemia, n = 12). Forty-four patients (88%) were treated with anticoagulants. Recanalization of the vein was significantly more successful in patients with acute thrombosis (65% versus 37%, P = 0.05).
PMVT can occur when IBD is inactive, and its diagnosis was fortuitous in 40% of our cases. Screening for prothrombotic disorders is essential because it is positive in more than one third of cases.
炎症性肠病（IBD）与深静脉血栓形成的风险较高相关。然而，目前关于门静脉血栓形成（PMVT）的数据很少。本研究的目的是描述 IBD 患者 PMVT 的特征。
这项回顾性研究是在 13 个 GETAID（胃肠道炎症治疗研究小组）中心进行的，时间从 1995 年 1 月至 2010 年 6 月。使用标准化问卷收集了以下数据：IBD 的特征、PMVT 时的疾病状态、PMVT 的特征和发现方式、同时存在的血栓形成障碍、抗凝治疗以及 PMVT 的演变。
共确定了 50 例患者（29 名男性和 21 名女性；中位年龄 41 岁），包括 14 例溃疡性结肠炎患者和 36 例克罗恩病患者。31 例患者（62%）出现急性 PMVT。24 例患者此前接受过手术治疗，23 例（77%）急性血栓形成患者的 IBD 处于活动期。在我们的病例中，有 40%的 PMVT 是偶然发现的。在筛查血栓形成障碍的 43 例患者中，有 17 例（40%）（主要为高同型半胱氨酸血症，n=12）发现异常。44 例（88%）患者接受抗凝治疗。急性血栓形成患者的静脉再通明显更成功（65%比 37%，P=0.05）。
IBD 不活跃时也可能发生 PMVT，我们的病例中有 40%是偶然发现的。筛查血栓形成障碍至关重要，因为三分之一以上的病例呈阳性。
