Chronic Mesenteric Venous Thrombosis: Evaluation and Determinants of Survival During Long-Term Follow-up

Background & Aims: The natural history of chronic portomesenteric (PM) and portosplenomesenteric (PSM) venous thrombosis is defined poorly. Therapeutic options are limited, and are directed at the prevention of variceal bleeding and the control of abdominal pain related to gastrointestinal hyperemia. Methods: Patients with extensive PM and PSM thrombosis were reviewed retrospectively to evaluate the efficacy of medical therapy and to determine which clinical variables had prognostic significance regarding long-term survival. Results: Sixty patients, with a median age at diagnosis of 44 years (range, 18–68 y), were assessed. The median follow-up period was 3.5 years (range, 0.2–32.0 y). The overall survival rate was 73.3%, with 1- and 5-year survival rates of 81.6%, and 78.3%, respectively. One- and 5-year survival rates, excluding patients who died from malignancy-related causes, were 85.7% and 82.1%, respectively. Factors associated with improved survival included treatment with β-blockers ( P = .02; odds ratio [OR], .09; 95% confidence interval [CI], 0.01–0.70) and anticoagulation ( P = .005; OR, 0.01; 95% CI,