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. 2023 Oct;93(10):2487-2491.
doi: 10.1111/ans.18442. Epub 2023 Mar 30.

Splanchnic vein thrombosis in acute pancreatitis: a review of treatment indications, methods, and outcomes in a single institution

Tamalee M Wilson  1 , Ali Daneshmand  1 , Simon Parys  2 , Yuki Watanabe  1
Affiliations

Splanchnic vein thrombosis in acute pancreatitis: a review of treatment indications, methods, and outcomes in a single institution

Tamalee M Wilson et al. ANZ J Surg. 2023 Oct.

Abstract

Background: Splanchnic vein thrombosis (SVT) is a well-recognized complication of acute pancreatitis. The question of whether or not to treat SVT with systemic therapeutic anticoagulation (STA) remains to be seen. The universal use of anticoagulation may lead to an increased risk of bleeding complications associated with acute pancreatitis. Literature on this subject is sparse and there is no clear guideline on how to treat SVT. Our research demonstrates local practice where therapeutic anticoagulation in SVT varies.

Methods: A retrospective review of patients presenting with acute pancreatitis admitted over a five-year period to a single tertiary hospital with splanchnic vein thrombosis was performed.

Results: Of the 1408 patients admitted with acute pancreatitis, 42 were diagnosed with splanchnic vein thrombosis, with a male dominance of 34 (81%). A total of 25 patients received anticoagulation. The use of anticoagulation was dependent on the location of the thrombus, P < 0.01. Anticoagulation use was most common in cases of combination mesenteric, splenic, and portal vein thrombus (100%), isolated mesenteric vein (100%), isolated portal vein (89%), combination portal and splenic vein (87%), and combination mesenteric and splenic vein (75%). The rate of anticoagulation use was lowest in isolated splenic vein thrombus (23%).

Conclusion: The early commencement of STA in patients with acute pancreatitis and triple-vessel SVT or with portal vein involvement is supported by our data. Isolated splenic vein thrombus does not require systemic therapy. Further research is needed to establish a clear clinical guideline.

Keywords: pancreatitis; splanchnic vein thrombosis; systemic therapeutic anticoagulation.

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References

    1. Nadkarni N, Khanna S, Vege S. Splanchnic venous thrombosis and pancreatitis. Pancreas 2013; 42: 924-31.
    1. Harris S, Nadkarni N, Naina HV, Vege SS. Splanchnic vein thrombosis in acute pancreatitis: a single-centre experience. Pancreas 2013; 42: 1251-4.
    1. Zhou J, Zhang H, Mao W et al. Efficacy and safety of early systemic anticoagulation for preventing splanchnic thrombosis in acute necrotising pancreatitis. Pancreas 2020; 49: 1220-4.
    1. Norton W, Lazaraviciute G, Ramsay G, Kreis I, Ahmed I, Bekheit M. Current practice of anticoagulant in the treatment of splanchnic vein thrombosis secondary to acute pancreatitis. Hepatobiliary Pancreat. Dis. Int. 2020; 19: 116-21.
    1. Pagliari D, Cianci R, Brizi MG et al. Anticoagulant therapy in the treatment of splanchnic vein thrombosis associated to acute pancreatitis: a 3-year single-centre experience. Int. Emerg. Med. 2020; 15: 1021-9.

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