Liver, Pancreas, and Biliary TractCurrent outcome of portal vein thrombosis in adults: Risk and benefit of anticoagulant therapy
Section snippets
Patients
All patients seen between 1983 and 1998 were enrolled if (1) they had been followed up at our institution; (2) portal venous thrombosis (endoluminal material and absence of flow in the portal vein or cavernous transformation of the vein) had been documented; (3) ongoing cancer had been excluded using all appropriate imaging and endoscopic procedures; (4) any kind of intrahepatic portal hypertension, including cirrhosis, had been excluded by normal liver function test results and normal aspect
Overall characteristics of the cohort
One hundred thirty-six patients were enrolled (74 men and 62 women). The median age at diagnosis of portal venous thrombosis was 43 years (range, 15–74 years). Initial manifestations were as follows: abdominal pain (n = 67), gastrointestinal bleeding related to portal hypertension (n = 24), mesenteric venous infarction (n = 7), ascites (n = 4), no clinical manifestations (i.e., fortuitous diagnosis; n = 10), and other clinical manifestations (n = 14). Portal venous thrombosis was demonstrated
Discussion
The natural history of portal vein thrombosis is unknown because in all reported cohorts of patients, some form of therapy has been administered for portal hypertension or thrombophilia. The rarity of portal vein thrombosis has not allowed controlled therapeutic trials to be conducted. Therefore, the influence of the various medical or surgical interventions remains ill-known. With these limitations as a background, the present survey has allowed re-evaluation of the outcome of portal vein
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Professor Hadengue's present address is: Hôpital Cantonal Universitaire 1211, Genève, Switzerland.
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fax: (33) 1-42-70-09-83.