P746 Prevalence, features and outcomes of splachnic vein thrombosis in inflammatory bowel disease. A nationwide, retrospective study from the ENEIDA registry
H. Masnou1, M. Mañosa2, L. Menchén3, F. Mesonero4, L. Bujanda5, J. Castro6, I. Gonzalez-Partida7, R. De Francisco8, F.J. García-Alonso9, M.J. García10, C. González-Muñoza11, J.M. Huguet12, M. Iborra13, N. Cano-Sanz14, E. Domènech Moral2, Eneida-GETECCU Registry
1H Germans Trias i Pujol Badalona, Gastroenterology, Badalona, Spain, 2H Germans Trias i Pujol Badalona & CIBEREHD, Gastroenterology, Badalona, Spain, 3H Gregorio Marañón, Gastroenterology, Madrid, Spain, 4H Universitario Ramón y Cajal, Gastroenterology, Madrid, Spain, 5H Donostia & CIBEREHD, Gastroetnerology, San Sebastián, Spain, 6H Clínic, Gastroenterology, Barcelona, Spain, 7H Puerta de Hierro, Gastroenterology, Madrid, Spain, 8H Universitario Central de Asturias and ISPA, Gastroenterology, Oviedo, Spain, 9H Rio Hortega, Gastroenterology, Valladolid, Spain, 10H Marqués de Valdecillas, Gastroenterology, Santander, Spain, 11H Santa Creu i Sant Pau, Gastroenterology, Barcelona, Spain, 12H General Universitario, Gastroenterology, Valencia, Spain, 13H Politècnic La Fe & CIBEREHD, Gastroenterology, Valencia, Spain, 14H de León, Gastroenterology, León, Spain
Background
The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vein and/or its intrahepatic branches, mesenteric, splenic and/or suprahepatic veïns is mainly observed, among others, in inflammatory abdominal conditions. Thromboembolic complications are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, characteristics, risk factors and evolution of SVT in patients with IBD. Our aims were to describe the characteristics of SVT in patients with IBD, diagnostic explorations, treatment and evolution.
Methods
Retrospective, multicentre, descriptive study of the ENEIDA registry with a diagnosis of SVT. In addition to epidemiological and clinical features of IBD, we recorded specifically diagnosis, treatment, disease activity at the time of SVT and outcome of SVT.
Results
Over 59,000 IBD patients in the ENEIDA registry, only 49 episodes of SVT were identified (35 Crohn’s / 14 Ulcerative Colitis); 69% men, median age 42 years old, 35% smokers. 37% had a past history of surgery and/or abdominal inflammatory conditions, 16% extra-intestinal neoplasia, 23% baseline immune or hematologic conditions and 14% liver disease. Finally, 16% had a previous episode of venous thrombosis. The most frequent forms of clinical presentation were abdominal pain with/without fever (59%), and radiological findings in the setting of active IBD (25%). ST coincided with IBD activity in 76% of cases. The diagnosis of SVT was based in the findings of an abdominal CT in 82%. The most frequent localition of SVT were intrahepatic portal branches (51%) and superior mesenteric vein (47%). Only 47% had a basic aetiological study, and 37% underwent gastroscopy (median 7 months from the diagnosis of SVT) showing oesophageal varices in 67%. Anticoagulation therapy was prescribed in 94% of the episodes (74% within the first month since diagnosis), for a median of 7 months. In 90% of the cases, there was a further radiological assessment, 61% of which showing the resolution of the SVT (median of 5 months from the beginning anticoagulation treatment).
Conclusion
SVT seems to be a rare (or underdiagnosed) complication in IBD patients, it is mostly associated with disease activity and evolves suitably when anticoagulation therapy is suitably started.