- 作者：Juan Turnes?/sup> ; &Dagger ; ; Juan Carlos Garcí ; a– ; Pagá ; n?/sup> ; &Dagger ; ; jcgarcia@clinic.ub.es ; Monica Gonzá ; lez&Dagger ; ; § ; ; Carles Aracil&Dagger ; ; ?/sup> ; José ; Luí ; s Calleja¶ ; ; Cristina Ripoll&Dagger ; ; # ; Juan G. Abraldeṣ ; ?/sup> ; &Dagger ; ; Rafael Bañ ; ares&Dagger ; ; # ; Cá ; ndido Villanueva&Dagger ; ; ?/sup> ; Agustí ; n Albillos&Dagger ; ; § ; ; Juan Ramó ; n Ayuso?? ; Rosa Gilabert&Dagger ; ; ?? ; Jaime Bosch?/sup> ; &Dagger ;
- 关键词：APVT ; acute portal vein thrombosis ; CT ; computed tomography
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2008
- 出版时间：December 2008
- 年：2008
- 卷：6
- 期：12
- 页码：1412-1417
- 全文大小：509 K
Background & Aims
Acute portal vein thrombosis (APVT) is a rare disorder that causes chronic portal hypertension if recanalization is not obtained. However, response to anticoagulation and long-term prognosis of APVT are not well-defined.Methods
Thirty-eight patients diagnosed with APVT between 1995 and 2003 from 5 Spanish referral hospitals, in whom cirrhosis and malignancy were specifically excluded, were included in this retrospective study. The response to anticoagulation therapy and development of portal hypertension¨Crelated complications during follow-up were evaluated.
Results
Mean follow-up was 43 months (range, 6?12 months). Recanalization occurred in 12 of 27 patients receiving anticoagulation versus 0 of 11 patients who did not receive anticoagulation (P = .008). Rates of recanalization were influenced by the precocity of heparin administration and the number of underlying prothrombotic conditions. Follow-up upper endoscopy performed in 29 patients disclosed gastroesophageal varices in 16 (55 % ). Varices appeared as early as 1 month after APVT. However, in most patients varices were detected in successive endoscopies, mainly during the first year. Two-year actuarial probability of variceal bleeding was 12 % and for ascites 16 % . Five-year survival was 87 % . Mortality was related to the APVT episode in 2 cases and to an underlying hematologic disorder in one.
Conclusions
Anticoagulation achieved recanalization in about 40 % of patients. Most patients not achieving recanalization will develop gastroesophageal varices during follow-up. However, development of variceal bleeding and ascites is infrequent, and survival is satisfactory.