Portal ven trombozlu hastaların retrospektif incelenmesi
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Date
2023
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Trakya Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Portal ven trombozu, prehepatik portal hipertansiyonun önemli nedenidir ve karaciğer sirozu başta olmak üzere maligniteler, inflamatuar hastalıklar, hematolojik hastalıklar ve tromboza genetik yatkınlık oluşturan durumlar gibi birçok nedenle gelişebilmektedir. Tanı anında siroz ile ilişkili portal ven trombozu ile sirotik olmayan portal ven trombozu arasındaki ayrımı yapmak çok önemlidir. Değerlendirme, prognoz ve tedavi iki hastalık grubu arasında farklılık göstermektedir. Çalışmamızda, 2005-2021 yılları arasında iç hastalıkları ve gastroenteroloji poliklinik ve servislerine başvuran ve portal ven trombozu tanısı almış 112 hastanın tıbbi kayıtları retrospektif olarak incelendi. Tüm tanılar radyolojik olarak ultrasonografi, manyetik rezonans görüntüleme veya bilgisayarlı tomografi ile en az biri veya birkaçı ile doğrulandı. Hastalarımızı sirotik ve sirotik olmayan grup olmak üzere öncelikle iki gruba ayırdık. Daha sonrasında her iki grup içerisinde portal ven trombozunun radyolojik olarak akut veya kronik olmak üzere ikişer guruba ayırdık. Tüm gruptaki veriler ayrı ayrı ve ortak olarak analiz edildi. Tüm hastaların %58'inin erkek cinsiyet, en sık başvuru şikayetinin karın ağrısı olduğunu saptadık. Sirotik olmayan portal ven trombozu hastalarının daha fazla karın ağrısı ile başvurduğunu belirledik. Sirotik portal ven trombozu grubundaki hastaların yaş ortalaması, sirotik olmayan portal ven trombozu grubuna oranla daha yüksek olduğunu saptadık. Tanı anında en sık başvuralan yöntemin ultrasonografi olduğunu ve sirotik gruptaki hastaların izole portal ven trombozunun daha fazla, sirotik olmayan hasta grubunda üç damarın birlikte trombozunun (splenik ven, süperior mezenterik ven ve portal ven) daha fazla olduğunu belirledik. Hastalarımızın %27,7'sinin antikoagülan tedavi alırken, sirotik olmayan hastaların sirotik hastalara oranla daha fazla antikoagülan tedavi aldığı görüldü. Antikoagülan alanların ise daha fazla oranda rekanalize olduğunu saptadık. Ayrıca sirotik olmayan hastalarda, sirotik gruba oranla daha fazla rekanalizasyon gözlendi. Sirotik portal ven trombozu grubunun ortalama sağkalım süresinin, sirotik olmayan portal ven trombozu grubuna oranla daha düşük olduğunu saptadık.
Portal vein thrombosis is an important cause of prehepatic portal hypertension. In addition, it can develop for many reasons such as liver cirrhosis, malignancies, inflammatory diseases, hematological diseases that can cause a genetic predisposition to thrombosis. It is very important to distinguish between cirrhosis-related portal vein thrombosis and non-cirrhotic portal vein thrombosis at the time of diagnosis. Evaluation, prognosis, and treatment differ between in the two disease groups. In our study, the medical records of 112 patients who were diagnosed with portal vein thrombosis and admitted to internal medicine and gastroenterology outpatient clinics and services between 2005 and 2021 were retrospectively reviewed. All diagnoses were confirmed radiologically with at least one or more of ultrasonography, magnetic resonance imaging or computer tomography. First of all, we divided our patients into two groups as cirrhotic and noncirrhotic patients. Then, we divided portal vein thrombosis into two groups radiologically as acute or chronic within both groups. We analyzed the data in the whole group together and separately. As a result of this study, we found that 58% of all patients were male, and abdominal pain was the most common complaint in all patient groups. It was found that patients with a diagnosis of non-cirrhotic portal vein thrombosis were more likely to present with abdominal pain. The mean age of the patients in the cirrhotic portal vein thrombosis group was found to be higher than in the non-cirrhotic portal vein thrombosis group. We determined that the most commonly used method at the time of diagnosis was ultrasonography, and isolated portal vein thrombosis was more common in patients in the cirrhotic group, and three-vessel thrombosis (splenic vein, superior mesenteric vein and portal vein) was more common in the non-cirrhotic patient group. It was noticed that 27.7% of our patients received anticoagulant treatment, while non-cirrhotic patients received more anticoagulant treatment than cirrhotic patients. Additionally, we found that those who received anticoagulant treatment were more recanalized. In addition, more recanalization was observed in non-cirrhotic patients than in the cirrhotic group. The mean survival time of the cirrhotic portal vein thrombosis group was found to be lower than the non-cirrhotic portal vein thrombosis group.
Portal vein thrombosis is an important cause of prehepatic portal hypertension. In addition, it can develop for many reasons such as liver cirrhosis, malignancies, inflammatory diseases, hematological diseases that can cause a genetic predisposition to thrombosis. It is very important to distinguish between cirrhosis-related portal vein thrombosis and non-cirrhotic portal vein thrombosis at the time of diagnosis. Evaluation, prognosis, and treatment differ between in the two disease groups. In our study, the medical records of 112 patients who were diagnosed with portal vein thrombosis and admitted to internal medicine and gastroenterology outpatient clinics and services between 2005 and 2021 were retrospectively reviewed. All diagnoses were confirmed radiologically with at least one or more of ultrasonography, magnetic resonance imaging or computer tomography. First of all, we divided our patients into two groups as cirrhotic and noncirrhotic patients. Then, we divided portal vein thrombosis into two groups radiologically as acute or chronic within both groups. We analyzed the data in the whole group together and separately. As a result of this study, we found that 58% of all patients were male, and abdominal pain was the most common complaint in all patient groups. It was found that patients with a diagnosis of non-cirrhotic portal vein thrombosis were more likely to present with abdominal pain. The mean age of the patients in the cirrhotic portal vein thrombosis group was found to be higher than in the non-cirrhotic portal vein thrombosis group. We determined that the most commonly used method at the time of diagnosis was ultrasonography, and isolated portal vein thrombosis was more common in patients in the cirrhotic group, and three-vessel thrombosis (splenic vein, superior mesenteric vein and portal vein) was more common in the non-cirrhotic patient group. It was noticed that 27.7% of our patients received anticoagulant treatment, while non-cirrhotic patients received more anticoagulant treatment than cirrhotic patients. Additionally, we found that those who received anticoagulant treatment were more recanalized. In addition, more recanalization was observed in non-cirrhotic patients than in the cirrhotic group. The mean survival time of the cirrhotic portal vein thrombosis group was found to be lower than the non-cirrhotic portal vein thrombosis group.
Description
Tıpta Uzmanlık
Keywords
Gastroenteroloji, Gastroenterology ; İç Hastalıkları
