Acute thrombosis of the splanchnic veins
P. Gertsch, J. Matthews, J. Lerut, P. Luder and L. H. Blumgart
Clinic for Visceral and Transplantation Surgery, Inselspital, University of Bern, Switzerland.
The consequence of an acute thrombosis in the splanchnic veins on the
viability of the intestine has not been well defined in the literature.
Spontaneous recovery or total necrosis of the bowel have both been
described. We treated seven patients with thrombosis of the splanchnic
veins and adopted a surgical approach in three patients with extended and
complete thrombosis of the superior mesenteric vein, portal vein, and
splenic vein, while four patients with partial thrombosis of the superior
mesenteric vein or protal vein recovered with conservative treatment. A
22-year literature review has identified 64 cases of acute thrombosis in
the splanchnic veins, with complete information regarding the location and
extent of the thrombosis, the treatment, and the outcome. Different
anatomical patterns of thrombosis with mortality rates varying between 0%
and 76% seem to be related to the extent and completeness of venous
obstruction.
