Portal vein thrombosis in adult Omani patients

A retrospective cohort study

Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare

Research output: Contribution to journalArticle

Abstract

Objectives: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37.5%) had chronic PVT. PVT was more common in males than females, (25 (64.1%) vs. 14 (35.8%), respectively, p = 0.020). The three most common clinical symptoms were abdominal pain (n = 25, 64.1%) followed by nausea (n = 12, 30.7%) and fever (n = 8, 20.5%) patients. Causative risk factors included prothrombotic states (17.9–28.2%) and local factors (20.5%) such as cholecystitis, cholangitis, and liver abscess. Complications were found in 23.0% of patients with PVT, namely variceal bleeding in seven patients (17.9%) patients and bowel ischemia in two patients (5.1%). Management with sclerotherapy was performed in all patients with variceal bleeding. Thrombectomy was done for one patient complicated with intestinal ischemia, but as it failed, he was treated with warfarin anticoagulation. Conclusions: This is the first study reflecting a real-life practice in PVT with possibly underlying inherited and acquired prothrombotic conditions as well as complications due to local and malignant conditions from Oman. We studied the prevalence, clinical presentation, underlying possible etiological factors, treatment, and outcomes. Since causative factors were found in 36 patients (92.3%), etiological screening seems worthwhile in every case with PVT, but thrombophilia screening may not be cost-effective.

Original languageEnglish
Pages (from-to)522-527
Number of pages6
JournalOman Medical Journal
Volume32
Issue number6
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Portal Vein
Thrombosis
Cohort Studies
Retrospective Studies
Ischemia
Oman
Hemorrhage
Liver Abscess
Thrombectomy
Cholecystitis
Sclerotherapy
Cholangitis
Thrombophilia
Warfarin
Tertiary Care Centers
Liver Cirrhosis
Nausea
Abdominal Pain
Fever
Cross-Sectional Studies

Keywords

  • Liver cirrhosis
  • Portal hypertension
  • Portal vein

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Portal vein thrombosis in adult Omani patients : A retrospective cohort study. / Al Hashmi, Khalid; Al Aamri, Lamya; Al Lamki, Sulayma; Pathare, Anil.

In: Oman Medical Journal, Vol. 32, No. 6, 01.11.2017, p. 522-527.

Research output: Contribution to journalArticle

Al Hashmi, Khalid ; Al Aamri, Lamya ; Al Lamki, Sulayma ; Pathare, Anil. / Portal vein thrombosis in adult Omani patients : A retrospective cohort study. In: Oman Medical Journal. 2017 ; Vol. 32, No. 6. pp. 522-527.
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abstract = "Objectives: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4{\%}) had cirrhosis of the liver, and 24 (61.5{\%}) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5{\%}) had acute PVT, whereas nine (37.5{\%}) had chronic PVT. PVT was more common in males than females, (25 (64.1{\%}) vs. 14 (35.8{\%}), respectively, p = 0.020). The three most common clinical symptoms were abdominal pain (n = 25, 64.1{\%}) followed by nausea (n = 12, 30.7{\%}) and fever (n = 8, 20.5{\%}) patients. Causative risk factors included prothrombotic states (17.9–28.2{\%}) and local factors (20.5{\%}) such as cholecystitis, cholangitis, and liver abscess. Complications were found in 23.0{\%} of patients with PVT, namely variceal bleeding in seven patients (17.9{\%}) patients and bowel ischemia in two patients (5.1{\%}). Management with sclerotherapy was performed in all patients with variceal bleeding. Thrombectomy was done for one patient complicated with intestinal ischemia, but as it failed, he was treated with warfarin anticoagulation. Conclusions: This is the first study reflecting a real-life practice in PVT with possibly underlying inherited and acquired prothrombotic conditions as well as complications due to local and malignant conditions from Oman. We studied the prevalence, clinical presentation, underlying possible etiological factors, treatment, and outcomes. Since causative factors were found in 36 patients (92.3{\%}), etiological screening seems worthwhile in every case with PVT, but thrombophilia screening may not be cost-effective.",
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N2 - Objectives: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37.5%) had chronic PVT. PVT was more common in males than females, (25 (64.1%) vs. 14 (35.8%), respectively, p = 0.020). The three most common clinical symptoms were abdominal pain (n = 25, 64.1%) followed by nausea (n = 12, 30.7%) and fever (n = 8, 20.5%) patients. Causative risk factors included prothrombotic states (17.9–28.2%) and local factors (20.5%) such as cholecystitis, cholangitis, and liver abscess. Complications were found in 23.0% of patients with PVT, namely variceal bleeding in seven patients (17.9%) patients and bowel ischemia in two patients (5.1%). Management with sclerotherapy was performed in all patients with variceal bleeding. Thrombectomy was done for one patient complicated with intestinal ischemia, but as it failed, he was treated with warfarin anticoagulation. Conclusions: This is the first study reflecting a real-life practice in PVT with possibly underlying inherited and acquired prothrombotic conditions as well as complications due to local and malignant conditions from Oman. We studied the prevalence, clinical presentation, underlying possible etiological factors, treatment, and outcomes. Since causative factors were found in 36 patients (92.3%), etiological screening seems worthwhile in every case with PVT, but thrombophilia screening may not be cost-effective.

AB - Objectives: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37.5%) had chronic PVT. PVT was more common in males than females, (25 (64.1%) vs. 14 (35.8%), respectively, p = 0.020). The three most common clinical symptoms were abdominal pain (n = 25, 64.1%) followed by nausea (n = 12, 30.7%) and fever (n = 8, 20.5%) patients. Causative risk factors included prothrombotic states (17.9–28.2%) and local factors (20.5%) such as cholecystitis, cholangitis, and liver abscess. Complications were found in 23.0% of patients with PVT, namely variceal bleeding in seven patients (17.9%) patients and bowel ischemia in two patients (5.1%). Management with sclerotherapy was performed in all patients with variceal bleeding. Thrombectomy was done for one patient complicated with intestinal ischemia, but as it failed, he was treated with warfarin anticoagulation. Conclusions: This is the first study reflecting a real-life practice in PVT with possibly underlying inherited and acquired prothrombotic conditions as well as complications due to local and malignant conditions from Oman. We studied the prevalence, clinical presentation, underlying possible etiological factors, treatment, and outcomes. Since causative factors were found in 36 patients (92.3%), etiological screening seems worthwhile in every case with PVT, but thrombophilia screening may not be cost-effective.

KW - Liver cirrhosis

KW - Portal hypertension

KW - Portal vein

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