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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

doi: 10.1097/MIB.0b013e31827eea5f
Original Clinical Articles

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.

Article first published online 4 February 2013

1Department of Hepato-Gastroenterology, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France

2Department of Hepato-Gastroenterology, Hôpital Saint Antoine, Paris, France

3Department of Hepato-Gastroenterology, Hôpital Beaujon, Clichy, France

4Department of Hepato-Gastroenterology, Hôpital Robert Debré, Reims, France

5Department of Hepato-Gastroenterology, Hôpital Pontchaillou, Rennes, France

6Department of Hepato-Gastroenterology, Hôpital Huriez, Lille, France

7Department of Hepato-Gastroenterology, Hôpital Charles Nicolle, Rouen, France

8Department of Hepato-Gastroenterology, Hôpital Louis Mourier, Colombes, France

9Department of Hepato-Gastroenterology, Hôpital Cochin, Paris, France

10Department of Hepato-Gastroenterology, Hôpital de l'Archet, Nice, France

11Department of Hepato-Gastroenterology, Hôpital Haut–Lévêque, Pessac, France

12Department of Hepato-Gastroenterology, Hôpital Rangueil, Toulouse, France

13Department of Hepato-Gastroenterology, Hôpital Saint\x{2013}Eloi, Montpellier, France

14Department of Hepato-Gastroenterology, Hôpital Saint Louis, Paris, France

15Department of Hepato-Gastroenterology, Hôpital Lariboisière, Paris, France.

Reprints: Stéphane Nahon, MD, Service d’hépatogastroentérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, 10 avenue du Général Leclerc, 93370 Montfermeil, France (e-mail: snahon@ch-montfermeil.fr).

The authors have no conflicts of interest to disclose.

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