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https://www.um.edu.mt/library/oar/handle/123456789/88595
Title: | Splanchnic vein thrombosis |
Authors: | Riva, Nicoletta Donadini, Marco P. Dentali, Francesco Squizzato, Alessandro Ageno, Walter |
Keywords: | Anticoagulants (Medicine) Anticoagulants (Medicine) -- Administration Thrombosis |
Issue Date: | 2012 |
Publisher: | Schattauer |
Citation: | Riva, N., Donadini, M. P., Dentali, F., Squizzato, A., & Ageno, W. (2012).Splanchnic vein thrombosis. Phlebologie,3, 135- 139. |
Abstract: | Splanchnic vein thrombosis (SVT) – including mesenteric, portal, splenic and supra-hepatic veins thrombosis – is an underdiagnosed disease, with heterogeneous clinical presentations and a non-negligible rate of incidental findings. The main risk factors include abdominal diseases or interventions (e.g. infections, cirrhosis, abdominal cancer or surgical procedures), haematological disorders (mainly myeloproliferative neoplasms), inherited thrombophilic states and hormonal imbalances. New biological markers of subclinical disorders have recently been identified: JAK2 mutation and flow cytometry for CD55 and CD59. Clinical manifestations are generally aspecific. During the acute phase, main symptoms can be abdominal pain, gastrointestinal bleeding and ascites; while long-term consequences include liver cirrhosis and portal hypertension. Advances in non-invasive vascular imaging (Doppler ultrasound, angio-computed tomography and magnetic resonance imaging), have improved the diagnosis of SVT. Alterations in blood tests may suggest an underlying haematological or hepatic disorder. The optimal treatment of SVT remains an open issue, since large clinical trials are lacking. Expert consensus recommend to treat acute symptomatic non-cirrhotic portal vein thrombosis with parenteral anticoagulation during the acute phase, followed by oral anticoagulants for at least 3 months, though lifelong treatment is recommended in case of persistent prothrombotic factors. In Budd-Chiari syndrome, anticoagulation is recommended for all patients in the absence of major contraindications. However, the risk to benefit-ratio of anticoagulant therapy, both in the acute phase and for the long-term secondary prevention, still needs to be better assessed. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/88595 |
Appears in Collections: | Scholarly Works - FacM&SPat |
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