ArticleBMC gastroenterology2025
Prediction of bowel resection due to bowel necrosis in recent portal vein thrombosis based on CT presentations and clinical data.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aims to identify predictors of bowel resection due to bowel necrosis in patients with recent portal vein thrombosis (PVT) based on computed tomography (CT) presentations and clinical data.
methodsThis retrospective study was conducted from January 2013 to June 2023 and included patients with noncirrhotic, nontumoral recent PVT. Patients were followed up from initial hospitalization until September 2023 or death. Presentations on CT images, laboratory tests, adverse events, and clinical outcomes were recorded. Independent predictors of bowel resection due to bowel necrosis were identified using univariate and multivariate logistic regression models.
resultsSeventy-six patients (mean age, 41.6 years ± 13.0; 57 males) were evaluated. All patients received low molecular weight heparin, fasting, and intravenous antibiotics during hospitalization, and long-term oral anticoagulation after discharge. CT imaging revealed completely occlusive main portal vein in 73.7% (56/76) of patients and partially occlusive in 26.3% (20/76). Thrombus extension into the superior mesenteric vein was present in 80.3% (61/76) of patients and into the splenic vein in 69.7% (53/76). Additionally, 44.7% (34/76) of patients were classified as high density (CT value of main portal vein ≥ 50 Hounsfield Units on unenhanced CT scans), while 55.3% (42/76) were classified as low density (CT value < 50 Hounsfield Units). Bowel resection was performed in 15.8% (12/76) of patients due to bowel necrosis. Independent predictors of bowel resection were low CT value of the portal vein thrombus and a high neutrophil count.
conclusionsIn patients with noncirrhotic, nontumoral recent PVT, a low CT value of the main portal vein thrombus and a high neutrophil count are important predictive factors for bowel resection due to bowel necrosis.
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