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Portomesenteric Vein Thrombosis in Patients With Inflammatory Bowel Disease.

By Cécilia Landman, Stéphane Nahon, Jacques Cosnes, Yoram Bouhnik, Hedia Brixi-Benmansour, Guillaume Bouguen, Jean-Frédéric Colombel, Guillaume Savoye, Benoit Coffin, Vered Abitbol, Jerôme Filippi, David Laharie, Jacques Moreau, Michel Veyrac, Matthieu Allez, Philippe Marteau and Non Renseigné

Abstract

International audienceBACKGROUND:: Inflammatory bowel disease (IBD) is associated with a high risk of deep venous thromboembolism. However, few data are available so far on portomesenteric vein thrombosis (PMVT). The aim of this study was to describe the characteristics of PMVT in patients with IBD. METHODS:: A retrospective study was conducted at 13 GETAID (Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif) centers from January 1995 to June 2010. The following data were collected, using a standardized questionnaire: characteristics of IBD, disease status at the time of PMVT, PMVT characteristics and mode of discovery, concomitant prothrombotic disorders, anticoagulant therapy, and evolution of PMVT. RESULTS:: Fifty cases (29 men and 21 women; median age, 41 years) were identified, including 14 patients with ulcerative colitis and 36 with Crohn's disease. Thirty-one patients (62%) presented with acute PMVT. Twenty-four patients had previously undergone surgical treatment, and IBD was active in 23 cases (77%) of acute thrombosis. The discovery of PMVT was fortuitous in 40% of our cases. Among the 43 patients screened for a prothrombotic disorder, abnormalities were observed in 17 patients (40%) (mainly hyperhomocysteinemia, n = 12). Forty-four patients (88%) were treated with anticoagulants. Recanalization of the vein was significantly more successful in patients with acute thrombosis (65% versus 37%, P = 0.05). CONCLUSIONS:: PMVT can occur when IBD is inactive, and its diagnosis was fortuitous in 40% of our cases. Screening for prothrombotic disorders is essential because it is positive in more than one third of cases

Topics: [ CHIM.ORGA ] Chemical Sciences/Organic chemistry
Publisher: Lippincott, Williams & Wilkins
Year: 2013
DOI identifier: 10.1097/MIB.0b013e31827eea5f
OAI identifier: oai:HAL:hal-00793619v1
Provided by: Hal-Diderot
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