Evidence-Based Medicine
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2014; 20(44): 16698-16701
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16698
Splanchnic vein thrombosis in necrotizing acute pancreatitis: Detection by computed tomographic venography
Wei Jiang, Jing Zhou, Lu Ke, Gang Li, Zhi-Hui Tong, Wei-Qin Li, Jie-Shou Li
Wei Jiang, Jing Zhou, Lu Ke, Gang Li, Zhi-Hui Tong, Wei-Qin Li, Jie-Shou Li, Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210000, Jiangsu Province, China
Author contributions: All authors contributed to this manuscript.
Correspondence to: Wei-Qin Li, MD, Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing 210000, Jiangsu Province, China. sicuabc@outlook.com
Telephone: +86-25-80860066 Fax: +86-25-80863387
Received: March 30, 2014
Revised: June 13, 2014
Accepted: July 11, 2014
Published online: November 28, 2014
Abstract

AIM: To assess the diagnostic accuracy of computed tomographic venography (CTV) for splanchnic vein thrombosis (SVT) detection in necrotizing acute pancreatitis (AP) patients.

METHODS: Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography (DSA) within 3 d were analyzed in this retrospective comparative study. All CTV procedures were performed with a dual-source CT scanner. The presence and location of SVT were determined via blinded imaging data analyses.

RESULTS: According to the DSA results, 17 (39.5%) of the total 43 patients had SVT. The sensitivity, specificity, positive and negative predictive values of CTV for SVT detection were 100% (95%CI: 77.1%-100%), 92.3% (95%CI: 73.4%-98.7%), 89.5% (95%CI: 65.5%-98.2%) and 100% (95%CI: 82.8%-100%), respectively.

CONCLUSION: CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values.

Keywords: Splanchnic vein, Thrombosis, Necrotizing acute pancreatitis, Computed tomographic venography, Digital subtraction angiography

Core tip: Computed tomographic venography (CTV) is an effective examination for splanchnic vein thrombosis (SVT) detection in necrotizing acute pancreatitis (AP) with high positive and negative predictive values. As a non-invasive and quick procedure, CTV might effectively replace digital subtraction angiography and be the routine imaging method for screening and assessing SVT in necrotizing AP patients.