Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding

Abstract

Although reported incidences of PISVT vary widely across studies, an overall incidence of 14.1% is reported. Splenomegaly is an unreliable sign of PISVT. Although the true natural history of PISVT remains unknown, the collective reported rate of associated GI bleeding is 12.3%.

Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review

“…LSPH is usually caused by SVT following acute or chronic pancreatitis or pancreatic carcinoma, which could alter the venous anatomy, reverse the direction of the gastric venous blood flow, and increase the pressure within the submucosal veins of the gastric fundus (Butler et al, 2011). In the present case, however, according to the CT angiography and enhanced CT scan, no sign of SVT or extrinsic compression was found.…”

“…Besides, the time between the onset of pancreatitis and bleeding was only 10 d. It implys that local inflammation without SVT or extrinsic compression could also induce severe LSPH and GI bleeding in a short time. According to Evans et al (1990) and Butler et al (2011), the incidence of SVT-related LSPH is up to 45% in patients with pancreatitis, with the frequency of GI bleeding ranging from 37%-100% in these studies (Johnston and Myers, 1973;Little and Moossa, 1981;Keith et al, Fig. 4 Enhanced CT scan during the follow-up period, three months after her discharge (a) The pancreas was intact with smooth envelop, and the spleen was partially infracted and was much smaller than that of three months ago.…”

Gastric variceal bleeding related with sinistral portal hypertension occurring secondary to splenic vein thrombosis developed as a complication of acute pancreatitis

“…In a recent meta analysis, splenic vein thrombosis incidence correlated with pancreatitis has been given as 14.1%, also acute pancreatitis rate as 22.6 % and chronic pancreatitis as 12.4% has been indicated. 8 Apart from pancreatic pathologies, some rare reasons such as infiltrative colon cancers, 9 perirenal abcess, 10 retroperitoneal fibrosis, splenic artery aneurysm, thrombophilic conditions can be counted.…”

“…In 77% of patients having SPH gastric varices have been determined and bleeding rate has been given as 12.3%. 8 SPH should be considered when the patient presents with gastrointestinal bleeding from gastric varices with normal liver function, splenomegaly and with no signs of cirrhosis.…”

Role of Thrombophilia in Splanchnic Venous Thrombosis in Acute Pancreatitis

“…In addition, spontaneous recanalization of a thrombosed splanchnic venous system has been reported in up to 30% of patients [15].…”