Canadian Journal of Gastroenterology and Hepatology

Canadian Journal of Gastroenterology and Hepatology / 2014 / Article

Original Article | Open Access

Volume 28 |Article ID 353672 | https://doi.org/10.1155/2014/353672

Pranavi Ravichandran, Kris P Croome, Michael J Kovacs, Alejandro Lazo-Langner, Roberto Hernandez-Alejandro, "Initial Management of Noncirrhotic Splanchnic Vein Thrombosis: When Is Anticoagulation Enough?", Canadian Journal of Gastroenterology and Hepatology, vol. 28, Article ID 353672, 5 pages, 2014. https://doi.org/10.1155/2014/353672

Initial Management of Noncirrhotic Splanchnic Vein Thrombosis: When Is Anticoagulation Enough?

Received05 Nov 2013
Accepted07 Feb 2014

Abstract

BACKGROUND: The optimal initial treatment of splanchnic vein thrombosis is uncertain. Anticoagulant therapy has been shown to be associated with vessel recanalization and decreased recurrence. Furthermore, information regarding potential predictors of chronic complications is not well understood.METHODS: A retrospective cohort study involving consecutive patients diagnosed with first-episode noncirrhotic splanchnic vein thrombosis referred to the thrombosis clinic of the authors’ institution between 2008 and 2011 was conducted. Demographic and clinical information was collected. The response to initial anticoagulant therapy was evaluated by determining radiographic recanalization of vessels and clinical resolution (defined as the absence of ongoing splanchnic vein thrombosis symptoms or complications requiring treatment beyond anticoagulant therapy).RESULTS: Twenty-two patients were included. Anticoagulant therapy alone resulted in vessel recanalization in 41% of patients and 68% achieved clinical resolution. Two patients experienced bleeding events. Factors associated with a lack of clinical resolution included signs of portal hypertension/liver failure on presentation, complete vessel occlusion at diagnosis, presence of a myeloproliferative disorder or JAK2V617F tyrosine kinase mutation and the absence of a local/transient predisposing factor.CONCLUSIONS: Anticoagulant therapy appeared to be an effective initial treatment in patients with splanchnic vein thrombosis. Clinical factors may help to identify patients who are at risk for developing complications thus requiring closer monitoring. These findings were limited by the small sample size and need to be explored in larger prospective studies.

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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