The risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset : A systematic review and meta-analysis

© 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology..

BACKGROUND: Splanchnic vein thrombosis is a complication of acute pancreatitis (AP) and is likely often underdiagnosed.

OBJECTIVES: We aimed to understand the time course and risk factors of splanchnic vein thrombosis in the early phase of AP.

METHODS: A systematic search was conducted using the PRISMA guidelines (PROSPERO registration CRD42022367578). Inclusion criteria were appropriate imaging techniques in adult AP patients, studies that reported splanchnic vein thrombosis data from the early phase, and reliable information on the timing of imaging in relation to the onset of pancreatitis symptoms or hospital admission. The proportion of patients with thrombosis with 95% confidence intervals (CI) was calculated using random-effects meta-analyses, and multiple subgroup analyses were performed.

RESULTS: Data from 1951 patients from 14 studies were analyzed. The proportion of patients with splanchnic vein thrombosis within 12 days after symptom onset was 0.13 (CI 0.07-0.23). The occurrence was lowest at 0.06 (CI 0.03-0.1) between 0 and 3 days after symptom onset, and increased fourfold to 0.23 (CI 0.16-0.31) between 3 and 11 days. On hospital admission, the proportion of patients affected was 0.12 (CI 0.02-0.49); it was 0.17 (CI 0.03-0.58) 1-5 days after admission. The prevalence in mild, moderate, and severe AP was 0.15 (CI 0.05-0.36), 0.26 (CI 0.15-0.43), and 0.27 (CI 0.17-0.4), respectively. Alcoholic etiology (0.31, CI 0.13-0.58) and pancreatic necrosis (0.55, CI 0.29-0.78, necrosis above 30%) correlated with increased SVT prevalence.

CONCLUSION: The risk of developing splanchnic vein thrombosis is significant in the early stages of AP and may affect up to a quarter of patients. Alcoholic etiology, pancreatic necrosis, and severity may increase the prevalence of splanchnic vein thrombosis.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

United European gastroenterology journal - (2024) vom: 24. Feb.

Sprache:

Englisch

Beteiligte Personen:

Borbély, Ruben Zsolt [VerfasserIn]
Szalai, Eszter Ágnes [VerfasserIn]
Philip, Bryan Mangalath [VerfasserIn]
Dobszai, Dalma [VerfasserIn]
Teutsch, Brigitta [VerfasserIn]
Zolcsák, Ádám [VerfasserIn]
Veres, Dániel Sándor [VerfasserIn]
Erőss, Bálint [VerfasserIn]
Gellért, Bálint [VerfasserIn]
Hegyi, Péter Jenő [VerfasserIn]
Hegyi, Péter [VerfasserIn]
Faluhelyi, Nándor [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Portal vein thrombosis
Portosplenomesenteric venous thrombosis
Splenic vein thrombosis
Superior mesenteric vein thrombosis

Anmerkungen:

Date Revised 24.02.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1002/ueg2.12550

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368908046