Acute Necrotizing Pancreatitis, Portosplenomesenteric Venous Thrombosis
Conditions
Keywords
acute necrotizing pancreatitis, acute pancreatitis, pancreas disease, anticoagulation, anticolagulant therapy, bleeding, Portosplenomesenteric Vein Thrombosis, splanchic venous thrombosis
Brief summary
Severe acute pancreatitis (AP) is a pathology with high morbidity and mortality. Portosplenomesenteric vein thrombosis is a well-known local complication of AP with a variable incidence, which can reach up to 50% in case of severe AP. However, there is no specific recommendation regarding the management of Portosplenomesenteric vein thrombosis. By analogy to all venous thrombosis, the European Society of Gastroenterology recommends curative anticoagulation. However, the efficacy of curative anticoagulation has never been evaluated by prospective studies. In addition, bleeding complications during AP occur in approximately 10% of patients and are associated with a poor prognosis. The investigators wish to conduct an observational multi-center study with epidemiologic aims, including all patients admitted for AP and with a diagnosis of portosplenomesenteric vein thrombosis. The aim of this study is to evaluate the therapeutic management of these patients, the efficacy and safety of anticoagulant treatment for the treatment of Portosplenomesenteric vein thrombosis, and their outcomes.
Detailed description
The investigators will include prospectively all patients admitted for AP with a computed tomography diagnosis of portosplenomesenteric vein thrombosis.
Interventions
OTHERobservational study
patients admitted for AP with portosplenomesenteric vein thrombosis.
Sponsors
Nantes University Hospital
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult Patients (age \> 18 years) with acute pancreatitis * AND a diagnosis on CT injected with portal time of portosplenomesenteric vein thrombosis or laminated veins (without passage of blood flow through the vessel but without visible intraluminal thrombus) will be included.
Exclusion criteria
* Patient under guardianship * Refusal to participate in research * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| incidence of anticoagulation therapy | up to 12 months | incidence defined as : the ratio of the number of patients on curative anticoagulant therapy to the number of patients admitted with AP and portosplenomesenteric vein thrombosis during the inclusion period |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| hospital mortality at D28 | Day 28 | evaluate the hospitality mortality at D28 of patients admitted for AP with portosplenomesenteric vein |
| hospital mortality at D90 | Day 90 | evaluate the hospitality mortality at D90 of patients admitted for AP with portosplenomesenteric vein |
| hospital mortality at 6 months | 6 months | evaluate the hospitality mortality at 6 months of patients admitted for AP with portosplenomesenteric vein |
| hospital mortality at 12 months | 12 months | evaluate the hospitality mortality at 12 months of patients admitted for AP with portosplenomesenteric vein |
| incidence of portal cavernoma | up to 12 months | evaluate the incidence of portal cavernoma of patients admitted for AP with portosplenomesenteric vein |
| evaluate the outcomes of Number of patients admitted for AP with portosplenomesenteric vein thrombosis | up to 12 months | — |
| incidence of occurrence of malabsorption | up to 12 months | evaluate the incidence of occurrence of malabsorption of patients admitted for AP with portosplenomesenteric vein |
| incidence of digestive ischemia | up to 12 months | evaluate the incidence of digestive ischemia of patients admitted for AP with portosplenomesenteric vein |
| incidence of hepatic ischemia | up to 12 months | evaluate the incidence of hepatic ischemia of patients admitted for AP with portosplenomesenteric vein |
| incidence of pancreatic necrosis | up to 12 months | evaluate the incidence of pancreatic necrosis of patients admitted for AP with portosplenomesenteric vein |
| incidence of type 2 diabetes secondary to AP | up to 12 months | evaluate the incidence of type 2 diabetes secondary to AP of patients admitted for AP with portosplenomesenteric vein |
Countries
France
Outcome results
None listed