Published online Sep 21, 2018. doi: 10.3748/wjg.v24.i35.4054
Peer-review started: May 4, 2018
First decision: June 6, 2018
Revised: June 17, 2018
Accepted: June 25, 2018
Article in press: June 25, 2018
Published online: September 21, 2018
The natural history of portosplenomesenteric vein thrombosis (PSMVT) was mostly reported to occur late during acute pancreatitis (AP). There is little data regarding risk factors for this complication in the early stage of severe acute pancreatitis (SAP).
We wanted to determine the potential risk factors for the development of PSMVT in SAP patients and further qualify independent risk factors.
To investigate the incidence and risk factors of PSMVT in the early stage of SAP.
Clinical outcomes and imaging measures were compared between 25 patients with PSMVT developed in the early stage of SAP and 115 patients without PSMVT. Independent risk factors were assessed by logistic regression analyses.
Twenty-five of the one hundred and forty (17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after AP onset. Balthazar’s computed tomography (CT) severity index scores, hypoalbuminemia (serum albumin level < 25 g/L) and gastrointestinal wall thickening were independent risk factors for PSMVT developed in patients with SAP. The area under the receiver operating characteristic (ROC) curve for Balthazar’s CT severity index scores was 0.777 with high specificity at a cut-off value of 5.5.
High Balthazar’s CT severity index scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.
High Balthazar’s CT severity index scores, hypoalbuminemia and gastrointestinal wall thickening may be good forecasting indictors for PSMVT at the early stage of SAP. We hope that a future prospective, multicenter study will study the prevention and therapy of PSMVT at the early stage of AP.