Inflammatory Bowel Diseases

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Inflammatory Bowel Diseases:
doi: 10.1097/MIB.0b013e31827eea5f
Original Clinical Articles

Portomesenteric Vein Thrombosis in Patients With Inflammatory Bowel Disease

Landman, Cécilia MD1; Nahon, Stéphane MD1; Cosnes, Jacques MD2; Bouhnik, Yoram PhD3; Brixi-Benmansour, Hedia MD4; Bouguen, Guillaume MD5; Colombel, Jean-Frédéric MD, PhD6; Savoye, Guillaume PhD7; Coffin, Benoit PhD8; Abitbol, Vered PhD9; Filippi, Jerôme MD10; Laharie, David PhD11; Moreau, Jacques MD12; Veyrac, Michel MD13; Allez, Matthieu PhD14; Marteau, Philippe PhD15; on behalf of Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif

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Background: Inflammatory bowel disease (IBD) is associated with a high risk of deep venous thromboembolism. However, few data are available so far on portomesenteric vein thrombosis (PMVT). The aim of this study was to describe the characteristics of PMVT in patients with IBD.

Methods: A retrospective study was conducted at 13 GETAID (Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif) centers from January 1995 to June 2010. The following data were collected, using a standardized questionnaire: characteristics of IBD, disease status at the time of PMVT, PMVT characteristics and mode of discovery, concomitant prothrombotic disorders, anticoagulant therapy, and evolution of PMVT.

Results: Fifty cases (29 men and 21 women; median age, 41 years) were identified, including 14 patients with ulcerative colitis and 36 with Crohn's disease. Thirty-one patients (62%) presented with acute PMVT. Twenty-four patients had previously undergone surgical treatment, and IBD was active in 23 cases (77%) of acute thrombosis. The discovery of PMVT was fortuitous in 40% of our cases. Among the 43 patients screened for a prothrombotic disorder, abnormalities were observed in 17 patients (40%) (mainly hyperhomocysteinemia, n = 12). Forty-four patients (88%) were treated with anticoagulants. Recanalization of the vein was significantly more successful in patients with acute thrombosis (65% versus 37%, P = 0.05).

Conclusions: PMVT can occur when IBD is inactive, and its diagnosis was fortuitous in 40% of our cases. Screening for prothrombotic disorders is essential because it is positive in more than one third of cases.

© Crohn's & Colitis Foundation of America, Inc.

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