Background: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis but can also be seen in non-cirrhotic patients. In this context, we present a single institution experience of PVT in our patient population contrasting the difference of presentation between both groups of PVT.

Methods: We retrospectively analyzed electronic medical records of patients with PVT (confirmed with radiographic criteria) from 2009 to 2018. We collected data regarding the demographics, characteristics of PVT, liver cirrhosis, presence of malignancy, treatment and laboratory investigations done at the time of diagnosis. Clinical endpoints of 90-death mortality, admission to intensive care unit and length of stay were also collected.

Results: a total of 162 patients fulfilled inclusion criteria. 104 (64.2%) male patients, mean age of 56.4, predominantly African American patients 75 (46.3%). 81 (50.0%) patients had cirrhotic PVT and 85 (52.5%) had malignant PVT. Most patients presented with abdominal pain 102 (63%), with an acute onset 51 (31.5%). 111 (68.5%) patients were not treated with anticoagulation. 28 (17.3%) patients died within 90 days of diagnosis and 22 (13.6%) patients were admitted to intensive care unit during same admission. When comparing Malignant with non-malignant PVT, patients with malignancy had a higher death rate 22 (30.1%) vs 6 (8.8%), p value <0.05. When comparing cirrhotic vs non-cirrhotic PVT, patients with cirrhosis had a higher MICU admission, history of HCC and they were treated with anticoagulation more.

Conclusion: In terms of etiology, PVT patients with malignancy seem to be doing worse than patients without malignancy while patients with cirrhosis except for higher rates for MICU admission; they seem to be doing similarly. Reasons for this discrepancy could be attributed to the fact that malignancies associated with high rates of PVT seem to be more aggressive in terms of mortality. Other studies need to be conducted in order to further clarify what we know about malignant and cirrhotic PVT.

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Disclosures

No relevant conflicts of interest to declare.

Topics:
portal vein thrombosis, cancer, liver cirrhosis, anticoagulation, abdominal pain, length of stay, surrogate endpoints, intensive care unit

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2019 by The American Society of Hematology
2019
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