Type 2 diabetes mellitus as a risk factor for intestinal resection in patients with superior mesenteric vein thrombosis
| Autor: | L. Boudaoud, Claire Francoz, Vanessa Bondjemah, Onorina Bruno, Kamal Zekrini, Frédéric Bretagnol, Dominique Valla, Pierre-Emmanuel Rautou, Emmanuelle de Raucourt, Francisca Joly, Yves Panis, Dominique Cazals-Hatem, Odile Goria, L. Elkrief, Béatrice Larroque, Sophie Hillaire, Olivier Corcos, Aurélie Plessier |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Cirrhosis Statistics Nonparametric Ischemia Risk Factors Diabetes mellitus Occlusion medicine Humans Superior mesenteric vein Risk factor Retrospective Studies Hepatology business.industry Hypertriglyceridemia Anticoagulants Middle Aged medicine.disease Surgery Portal vein thrombosis Intestines Diabetes Mellitus Type 2 Mesenteric Ischemia Female Complication business Tomography X-Ray Computed |
| Zdroj: | Liver international : official journal of the International Association for the Study of the Liver. 34(9) |
| ISSN: | 1478-3231 |
| Popis: | Background & Aims The most serious complication of acute mesenteric vein thrombosis (MVT) is acute intestinal ischaemia requiring intestinal resection or causing death. Risk factors for this complication are unknown. To identify risk factors for severe intestinal ischaemia leading to intestinal resection in patients with acute MVT. Methods We retrospectively analysed consecutive patients seen between 2002 and 2012 with acute MVT in 2 specialized units. Patients with cirrhosis were excluded. We compared patients who required intestinal resection to patients who did not. Results Among 57 patients, a local risk factor was identified in 14 (24%) patients, oral contraceptive use in 16 (29%), and at least one or more other systemic prothrombotic condition in 25 (44%). Five (9%) patients had diabetes mellitus (DM), 33 (58%) had overweight or obesity, 9 (18%) had hypertriglyceridemia and 10 (19%) had arterial hypertension. Eleven patients (19%) underwent intestinal resection. DM was significantly associated with intestinal resection (P = 0.02) while local factors or prothrombotic conditions were not. Computed tomography (CT) scans performed at diagnosis found that occlusion of second order radicles of the superior mesenteric vein was more frequently observed in patients who underwent intestinal resection (P = 0.009). Conclusions In acute MVT, patients with underlying DM have an increased risk of requiring intestinal resection. Neither local factors nor systemic prothrombotic conditions are associated with intestinal resection. When CT scan shows the preservation of second order radicles of the superior mesenteric vein, the risk of severe resection is low. |
| Databáze: | OpenAIRE |
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