Risk factors, pattern of presentation, methods of diagnosis, and results of treatment of acute portal vein thrombosis: A multicenter study

Abstract

Portal vein thrombosis (PVT) is a serious condition; however, the outcome may be improved by early recognition and prompt management. The aim of this multicenter retrospective study is to evaluate the underlying risk factors, pattern of presentation, methods of diagnosis, and results of treatment of cases of acute/recent PVT in Taif tertiary hospitals. Methods: In this chart review and database study, 103 patients met the inclusion criteria. Data extracted from the medical records were analyzed for underlying risk factors, pattern of presentation, diagnostic tools, and results of treatment. Results: The underlying causes of PVT were cirrhosis (46.6%) and noncirrhotic causes (43.7%), and no obvious cause was recorded in 9.7% of cases. In 9.7% of the patients, PVT progressed to mesenteric venous occlusion. The diagnosis was established by initial duplex ultrasound scan or/and contrast‑enhanced computed tomography scan in 97.1% of patients. Anticoagulation was started for all patients after established diagnosis except in patients with gastrointestinal bleeding. In all patients with mesenteric venous occlusion, infarcted segments were found and resected during abdominal exploration. The recorded overall mortality during follow‑up was 51.5%, and it was significantly higher in cirrhotic than in noncirrhotic patients (P < 0.05). Conclusions: Cirrhosis is the main underlying cause of PVT in Taif, Saudi Arabia. Most of the findings in this study about epidemiological and risk factors were quite different from that of other global findings. More studies are required to assess the actual magnitude of PVT in Taif and other Saudi Arabia provinces.