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急性胆囊炎患者的内脏静脉血栓形成:病例系列及文献综述

Splanchnic venous thrombosis in patients with acute cholecystitis: a case series and review of literature.

作者信息

Boccatonda Andrea, Campello Elena, Tallarico Viola, D'Ardes Damiano, Cipollone Francesco, Simioni Paolo, Schiavone Cosima, Piscaglia Fabio, Serra Carla

机构信息

Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy.

Internal Medicine 1, Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Padua, Italy.

出版信息

J Ultrasound. 2025 May 30. doi: 10.1007/s40477-025-01029-4.

Abstract

Portal vein thrombosis (PVT) is a rare vascular disorder with an estimated incidence of 2-4 cases per 100,000 inhabitants. Although chronic liver disease (especially cirrhosis), hepatobiliary malignancies, major infectious/inflammatory abdominal diseases, and myeloproliferative disorders are well-recognized predisposing conditions for PVT, various abdominal inflammatory processes can also predispose to visceral venous thrombosis. In this article, we present a case series of three patients with a clinical diagnosis of acute cholecystitis complicated by visceral venous thrombosis. We describe the clinical presentation, imaging findings, therapeutic approaches-including the use of injectable anticoagulants and direct oral anticoagulants (DOACs)-and the impact of venous thrombosis on the timing of definitive surgical treatment. We also discuss the implications of these findings in the context of current knowledge and propose management strategies for similar cases.

摘要

门静脉血栓形成(PVT)是一种罕见的血管疾病,估计发病率为每10万居民中有2 - 4例。虽然慢性肝病(尤其是肝硬化)、肝胆恶性肿瘤、主要的腹部感染/炎症性疾病以及骨髓增殖性疾病是公认的PVT易感因素,但各种腹部炎症过程也可能导致内脏静脉血栓形成。在本文中,我们介绍了一组三例临床诊断为急性胆囊炎并发内脏静脉血栓形成的病例。我们描述了临床表现、影像学检查结果、治疗方法——包括使用注射用抗凝剂和直接口服抗凝剂(DOACs)——以及静脉血栓形成对确定性手术治疗时机的影响。我们还在当前知识背景下讨论了这些发现的意义,并提出了类似病例的管理策略。

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