Splanchnic vein thrombosis


Authors: Sylva Lajzová 1;  Radek Kroupa 1;  Alena Buliková 2;  Šárka Bohatá 3;  Barbora Packová 1;  Michal Šenkyřík 1
Authors‘ workplace: Interní gastroenterologická klinika LF MU a FN Brno, pracoviště Bohunice 1;  Oddělení klinické hematologie FN Brno, pracoviště Bohunice 2;  Klinika radiologie a nukleární medicíny LF MU a FN Brno, pracoviště Bohunice 3
Published in: Vnitř Lék 2018; 64(3): 272-279
Category: Reviews

Splanchnická žilní trombóza (SŽT) je méně obvyklou manifestací žilního tromboembolizmu. V etiologii SŽT hrají roli příčiny lokální i systémové, často kombinovaně. SŽT může být první manifestací myeloproliferativní neoplazie. Pacienti se SŽT jsou ohroženi ischemií střeva a ztrátou jeho vitality, poškozením funkce jater a rozvojem portální hyper­tenze s rizikem život ohrožujícího gastrointestinálního krvácení. Současná léčebná doporučení zdůrazňují roli antikoagulace zejména u akutní SŽT. S ohledem na potenciálně fatální komplikace však musí být přínos i rizika nasazení antikoagulační terapie zvážena individuálně. Délka antikoagulační terapie je ponejvíce závislá na posouzení rizika rekurence trombózy. Tento článek přináší aktuální přehled o příčinách, diagnostice a aspektech ovlivňujících léčebnou strategii.

Overview

Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis. Considering the potentially fatal complications it is necessary to tailor the anticoagulant treatment individually. The duration of anticoagulant therapy is strongly dependent upon the risk evaluation of thrombosis recurrence. The article deals with the causes, diagnostic methods and aspects influencing the therapeutic strategy.

Key words:
anticoagulation – liver cirrhosis – portal hypertension – prothrombotic state – splanchnic vein thrombosis


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