Therapeutic Anticoagulation for Splanchnic Vein Thrombosis in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Sissingh, Noor J.; Groen, Jesse V.; Koole, D.; Klok, Frederikus A.; Boekestijn, Bas; Bollen, T.L.; Santvoort, Hjalmar C. van; Verdonk, R.C.; Bonsing, B.; Eijck, Casper H.J. van; Hooft, Jeanin E. van; Mieog, J. Sven D.

doi:10.1016/j.hpb.2022.05.516

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…However, no clear literature or guidelines exist. A meta-analysis by Sissingh et al 13 compared therapeutic anticoagulation against no intervention in those with SVT secondary to acute pancreatitis and was ultimately unable to prove a benefit in mortality, rates of recanalization, or formation of varices in either group. Further randomized clinical trials are needed to illustrate the benefit of anticoagulation in these cases.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding Secondary to Splenic Artery Pseudoaneurysm: A Delayed Complication of a Lumen-Apposing Metal Stent

et al. 2023

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Lumen-apposing metal stents (LAMSs) have been widely used for drainage of peripancreatic collections. A 71-year-old woman with a history of necrotizing pancreatitis who underwent LAMS placement 3 months ago for symptomatic pancreatic fluid collection presented with hematochezia and hemodynamic instability. Computed tomographic angiography of the abdomen showed concerns for stent erosion into the splenic artery. Esophagogastroduodenoscopy revealed a large pulsating nonbleeding vessel within the LAMS. She underwent a mesenteric angiogram, which showed splenic artery pseudoaneurysm, and coil embolization was performed. Gastrointestinal bleeding secondary to pseudoaneurysm should be considered in patients with recent LAMS placement who present with signs of gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding Secondary to Splenic Artery Pseudoaneurysm: A Delayed Complication of a Lumen-Apposing Metal Stent

et al. 2023

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“…3 Other causes include intraabdominal surgery or infections, pancreatitis, inflammatory bowel diseases, thrombophilia, and myeloproliferative neoplasms (MPNs). 3,4 Anticoagulation is the cornerstone of SVT management, intended to prevent thrombus extension and recurrent thrombosis, while carefully balancing the risk of hemorrhage. [5][6][7] This narrative review aims to summarize the latest evidence on SVT, with a particular focus on recent updates regarding the anticoagulant treatment.…”

Section: Introductionmentioning

confidence: 99%

Splanchnic Vein Thrombosis: The State-of-the-Art on Anticoagulant Treatment

Custo,

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Aquilina

et al. 2024

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Splanchnic vein thrombosis (SVT) is a rare type of venous thromboembolism occurring within the splanchnic venous system. Portal vein thrombosis is the most common presentation, while Budd–Chiari syndrome is the least common. Liver cirrhosis and abdominal solid cancer are the main local risk factors for SVT, whereas myeloproliferative neoplasms are the predominant systemic risk factors. Signs and symptoms of SVT are nonspecific and include abdominal pain, gastrointestinal bleeding, and ascites. Asymptomatic SVT is not uncommon, and the majority would be detected incidentally on routine abdominal imaging performed for the follow-up of liver diseases and tumors. The management of SVT aims to prevent thrombus progression, promote vessel recanalization, and prevent recurrent venous thromboembolism. Anticoagulation should be started early in order to increase the chances of vessel recanalization and reduce the risk of portal hypertension-related complications. Direct oral anticoagulants have been included in recent guidelines, as alternatives to vitamin K antagonists, after clinical stability has been reached; however, caution is required in patients with liver or kidney dysfunction. Treatment duration is based on the presence (or absence) and type (transient vs. permanent) of risk factors. This narrative review aims to summarize the latest evidence on SVT, with a particular focus on the anticoagulant treatment in special categories of patients (e.g., liver cirrhosis, solid cancer, myeloproliferative neoplasms, pancreatitis, incidentally detected SVT, Budd–Chiari syndrome, and chronic SVT).

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Therapeutic Anticoagulation for Splanchnic Vein Thrombosis in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Cited by 2 publications

References 38 publications

Gastrointestinal Bleeding Secondary to Splenic Artery Pseudoaneurysm: A Delayed Complication of a Lumen-Apposing Metal Stent

Gastrointestinal Bleeding Secondary to Splenic Artery Pseudoaneurysm: A Delayed Complication of a Lumen-Apposing Metal Stent

Splanchnic Vein Thrombosis: The State-of-the-Art on Anticoagulant Treatment

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