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Central splanchnic venous thrombosis. Often unsuspected, usually uncomplicated
1Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
Journal of Clinical Gastroenterology
|March 1, 1994
Summary
Central splanchnic venous thrombosis (CSVT) is often detected noninvasively but poorly understood. While CSVT itself is usually self-limiting, associated conditions frequently cause mortality.
Area of Science:
- Vascular Medicine
- Gastroenterology
- Radiology
Background:
- Central splanchnic venous thrombosis (CSVT) is increasingly detected noninvasively.
- Its pathophysiology and clinical significance are not fully understood.
Purpose of the Study:
- To review the characteristics, diagnostic methods, and outcomes of CSVT.
- To clarify the clinical significance and management implications of CSVT.
Main Methods:
- Retrospective review of 50 consecutive cases of CSVT.
- Analysis of diagnostic modalities including angiography, ultrasonography, CT, and MRI.
- Evaluation of patient demographics, associated conditions, clinical presentation, and outcomes.
Main Results:
- Portal and splenic veins were most commonly affected.
- Cancer, splanchnic venous stasis, and postoperative states were common predisposing factors.
- CSVT was often clinically unsuspected and asymptomatic, with variceal hemorrhage and abdominal pain as key symptoms.
- Most deaths were due to underlying diseases, not CSVT itself.
Conclusions:
- CSVT is frequently detected but often clinically unsuspected.
- The condition typically has a self-limited, nonlethal course.
- Treatment and prognosis should be guided by clinical context and associated conditions, not solely by the presence of CSVT.