Žilní trombóza splanchnického povodí: etiologie, léčba a výsledky. Retrospektivní analýza.

Abstract

Summary

Splanchnic vein thrombosis belongs to thrombosis at the unusual site. It includes portal vein thrombosis, mesenteric vein thrombosis, thrombosis of vein lienalis and Budd-Chiari syndrome. Etiology of thrombosis is usually multifactorial, causes can be as systematic or as local. However, etiology remains sometimes unclear. Thromboses also occur after abdominal surgery. The management of these patients is not unitary, because of low incidence and absence of specific guidelines. We retrospectively analysed cohort of 40 patients (15 males, 25 females, mean age 38 year) with focus on etiology, therapy and further management from two regions of our republic. Etiology was identified in 21 patients with predominace of JAK-2 kinase. In all cases thrombosis was objectively detected by Doppler ultrasound or angio-CT. Anticoagulation therapy with low molecular weight heparin (LMWH) was therapy of choice in all cases with schwitching into warfarin or direct oral anticoagulants (DOAC). The prognosis of splanchnic vein thrombosis depends on severity and localisation of thrombosis, its etiology and on early introduction of therapy.