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World J Gastroenterol. Apr 7, 2006; 12(13): 2115-2119
Published online Apr 7, 2006. doi: 10.3748/wjg.v12.i13.2115
Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23 796 consecutive autopsies
Mats Ögren, David Bergqvist, Martin Björck, Stefan Acosta, Henry Eriksson, Nils H Sternby
Mats Ögren, David Bergqvist, Martin Björck, Department of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden
Stefan Acosta, Nils H Sternby, Departments of Vascular Diseases and Pathology, Lund University, Malmö University Hospital, Malmö, Sweden
Henry Eriksson, Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr Mats Ögren, Department of Vascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala,Sweden. mats.ogren@astrazeneca.com
Telephone: +46-709-727030 Fax: +46-31-7763745
Received: July 27, 2005
Revised: August 16, 2005
Accepted: August 26, 2005
Published online: April 7, 2006
Abstract

AIM: To assess the lifetime cumulative incidence of portal venous thrombosis (PVT) in the general population.

METHODS: Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmö city population, were performed, using a standardised protocol including examination of the portal vein. PVT patients were characterised and the PVT prevalence at autopsy, an expression of life-time cumulative incidence, assessed in high-risk disease categories and expressed in terms of odds ratios and 95% CI.

RESULTS: The population prevalence of PVT was 1.0%. Of the 254 patients with PVT 28% had cirrhosis, 23% primary and 44% secondary hepatobiliary malignancy, 10% major abdominal infectious or inflammatory disease and 3% had a myeloproliferative disorder. Patients with both cirrhosis and hepatic carcinoma had the highest PVT risk, OR 17.1 (95% CI 11.1 - 26.4). In 14% no cause was found; only a minority of them had developed portal-hypertension-related complications.

CONCLUSION: In this population-based study, PVT was found to be more common than indicated by previous clinical series. The markedly excess risk in cirrhosis and hepatic carcinoma should warrant an increased awareness in these patients for whom prospective studies of directed intervention might be considered.

Keywords: Epidemiology; Venous thrombosis; Portal hypertension; Cirrhosis; Gastrointestinal cancer