Splanchnic Venous Thrombosis (SVT) Case Series at a Tertiary Care Hospital: Exploring Clinical Presentation, Diagnosis, Etiology, Thrombophilia, Treatment, and Outcome

Background

Splanchnic vein thrombosis (SVT) is an uncommon, but potentially life-threatening disease.

Aims

The aim was to gather more information on most common clinical presentations, risk factors, and treatment outcomes with anticoagulant therapy of SVT patients.

Methods

A retrospective study for 100 patients diagnosed with SVT confirmed by radiological imaging. Variables about demographics and history, signs and symptoms, risk factors, and treatment were collected from patients medical charts.

Results

The age group and the age of diagnosis of the patients was mainly 26-40 (40% and 46% respectively). 19% of patients had positive family history. The most affected veins were multiple veins (42%), followed by portal vein (34%), and then the superior mesenteric vein (11%). Recurrence was seen in 12% of patients. SVT was unprovoked in 48% of our patients and provoked in 52% commonly associated with significant trauma (29%), surgery (18%) in which bariatric surgery was the main culprit (11%) followed by colon/small intestine surgery (9%). 56% of the patients presented with abdominal pain, and 21% had abdominal distension, 9% had melena and 9% had splenomegaly. Thrombophilia was seen in 19% of the patients. Maintenance of anticoagulation was mostly by Warfarin (89%) and Rivaroxaban (9%). Duration of anticoagulation was extended (more than one year) in 72% of patients. 12% of patients had mesenteric ischemia and required bowel resection.

Conclusions

Anticoagulant therapy, in addition to surgery, showed excellent outcome in most patients with SVT. The most common provoking factors were trauma and bariatric surgery. Rivaroxiban demonstrated good safety and efficacy profile and can offer an alternative to traditional therapy in SVT patients.