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 27 May 2018

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News

Portal vein thrombi after restorative proctocolectomy

Portal vein thrombi is be found in a high proportion of patients undergoing abdominal CT scan after restorative proctocolectomy, find researchers in the latest issue of Surgery.

News image

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Since 1978, restorative proctocolectomy (RP) has been the surgical procedure of choice for the surgical management of mucosal ulcerative colitis.

In this study, researchers from Cleveland, Ohio, sought to investigate the clinical presentation and implications of portal vein thrombi (PVT) following RP.

The research team reviewed all patients undergoing RP in their institution, between 1997 and 2000.

The team confined their incidence estimate to 94 patients having an abdominal CT scan postoperatively.

Indications for CT scan included abdominal pain, fever, leukocytosis, and delayed bowel function.

PVT diagnosed in 45% of the patients receiving CT scan postoperatively.
Surgery
All scans were reviewed by an experienced radiologist.

In addition, the researchers recorded patient demographics, symptoms, and clinical course.

The research team diagnosed PVT in 45% of the patients.

The team found that septic complications of RP caused symptoms in 45 patients, 20 of whom had PVT.

However, 22 patients were found to have had PVT without evidence of any septic source.

Dr Feza Remzi's team concluded, "PVT can be found in a high proportion of patients undergoing abdominal CT scan after RP".

"It is often associated with pain, fever, nausea vomiting, tenderness, and leukocytosis.

"This study shows that PVT subtle enough to go undiagnosed has no serious consequences, even when not treated.

"Also, patients treated with anticoagulation recover completely".

Surgery 2002; 132: 655-62
04 November 2002

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