Splanchnic vein thrombosis in necrotizing acute pancreatitis: Detection by computed tomographic venography

World J Gastroenterol. 2014 Nov 28;20(44):16698-701. doi: 10.3748/wjg.v20.i44.16698.

Abstract

Aim: To assess the diagnostic accuracy of computed tomographic venography (CTV) for splanchnic vein thrombosis (SVT) detection in necrotizing acute pancreatitis (AP) patients.

Methods: Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography (DSA) within 3 d were analyzed in this retrospective comparative study. All CTV procedures were performed with a dual-source CT scanner. The presence and location of SVT were determined via blinded imaging data analyses.

Results: According to the DSA results, 17 (39.5%) of the total 43 patients had SVT. The sensitivity, specificity, positive and negative predictive values of CTV for SVT detection were 100% (95%CI: 77.1%-100%), 92.3% (95%CI: 73.4%-98.7%), 89.5% (95%CI: 65.5%-98.2%) and 100% (95%CI: 82.8%-100%), respectively.

Conclusion: CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values.

Keywords: Computed tomographic venography; Digital subtraction angiography; Necrotizing acute pancreatitis; Splanchnic vein; Thrombosis.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Angiography, Digital Subtraction
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis, Acute Necrotizing / complications*
  • Phlebography / methods*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Splanchnic Circulation
  • Splenic Vein / diagnostic imaging*
  • Splenic Vein / physiopathology
  • Tomography, X-Ray Computed*
  • Venous Thrombosis / diagnostic imaging*
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / physiopathology