The natural history of chronic portomesenteric and portosplenomesenteric venous thrombosis is defined poorly.
Therapeutic options are limited, and are directed at the prevention of variceal bleeding and the control of abdominal pain related to gastrointestinal hyperemia.
Dr David Orr and colleagues from England retrospectively reviewed patients with extensive portomesenteric and portosplenomesenteric thrombosis.
The research team evaluated the efficacy of medical therapy.
The team determined which clinical variables had prognostic significance regarding long-term survival.
|Overall 5-year survival rates were 78%|
|Clinical Gastroenterology & Hepatology|
The researchers assessed 60 patients, with a median age at diagnosis of 44 years.
The median follow-up period was 4 years.
The overall survival rate was 73%, with 1- and 5-year survival rates of 82%, and 78%, respectively.
The research team found that the 1- and 5-year survival rates in patients who did not die from malignancy-related causes were 86 % and 82 %, respectively.
Factors associated with improved survival included treatment with ß-blockers and anticoagulatives.
The team observed that 18 patients in total were anticoagulated, including 8 patients who had variceal bleeding.
All of these patients underwent endoscopic band ligation of esophageal varices before anticoagulation.
By using Cox regression analysis, variables associated with reduced survival were the presence of ascites, and hyperbilirubinemia at presentation.
The researchers noted that 6 patients died of variceal hemorrhage.
Dr Orr's team concluded, “Patients with chronic portomesenteric and portosplenomesenteric venous thrombosis without underlying malignancy have an acceptable long-term survival.”
“Treatment with ß-blockers and anticoagulation appears to improve outcome.”