Document Detail


Prognostic factors and treatment outcome in mesenteric vein thrombosis.
MedLine Citation:
PMID:  18332399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. METHODS: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. RESULTS: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P < .002), age >60 years (P < .005), cirrhosis (P < .02), symptom duration (P < .005), and bowel resection (P < .03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P = .03), malignancy (OR, 3.88; P = .02), and prolonged symptom duration (OR, 5.62; P = .01) were independent predictors of mortality. CONCLUSIONS: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome.
Authors:
Nasim Hedayati; Gordon M Riha; Panagiotis Kougias; Tam T Huynh; Charlie Cheng; Carlos Bechara; Jean Bismuth; Alan Dardik; Peter H Lin
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Publication Detail:
Type:  Journal Article     Date:  2008-03-10
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  42     ISSN:  1538-5744     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:    2008 Jun-Jul
Date Detail:
Created Date:  2008-07-31     Completed Date:  2008-10-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  217-24     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants / administration & dosage*
Drug Administration Schedule
Female
Humans
Logistic Models
Male
Mesenteric Vascular Occlusion / mortality,  radiography,  therapy*
Mesenteric Veins / surgery
Middle Aged
Neoplasms / complications
Odds Ratio
Retrospective Studies
Risk Assessment
Risk Factors
Thrombectomy*
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Venous Thrombosis / mortality,  radiography,  therapy*
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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