Portomesenteric venous thrombosis: a community hospital experience with 103 consecutive patients

Background

Portomesenteric venous thrombosis (PMVT) is uncommon but associated with ischemic bowel and mortality.

Objective

The purpose of this study was to determine the occurrence of PMVT in a community setting and evaluate current diagnosis, treatment, and outcomes.

Methods

Medical records of consecutive patients admitted to a community-based hospital diagnosed with PMVT were reviewed. Patients were divided into 2 groups: those diagnosed from 1997 to 2003 and those diagnosed from 2004 to 2009.

Results

One hundred three patients were included. The proportion of chronic PMVT diagnoses increased in the recent group (14% in contrast to 44%, P = .001). Treatment was more common in acute in contrast to chronic PMVTs (70% in contrast to 48%, P = .035). The median length of stay decreased over time (6 in contrast to 3 days, P = .004). Three patients underwent surgical intervention. Overall, 30-day mortality was 17% and did not change over time.

Conclusions

Diagnosis and treatment have changed with increased differentiation between acute and chronic PMVT; outcomes were similar. Surgical intervention was rarely necessary. Mortality is attributed to patient comorbidity rather than PMVT.