Splenic Vein Involvement or Pancreatic Portal Hypertension in Acute Pancreatitis: A Retrospective Characteristic Study
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i4.4822
Abstract
This study analyzed the characteristics of acute pancreatitis (AP) complicated by splenic vein involvement, with or without pancreatic portal hypertension (PPH). Methods: A retrospective review was performed on 225 AP cases that met specific inclusion and exclusion criteria. Patients were classified into three groups: the PPH group, the splenic vein nvolvement group (patients with splenic vein inflammation or thrombosis, without PPH), and the normal splenic vein group (patients without splenic vein involvement or PPH). Imaging and clinical features were documented for each group, including pancreatic necrosis, local complications, ascites, splenomegaly, MCTSI, gender, age, smoking and drinking history, prior history of AP, time from onset to CT scanning, and length of hospital stay. Statistical analyses included chi-square tests, analysis of variance, or the Kruskal-Wallis test. Results: The PPH and splenic vein stenosis or thrombosis groups exhibited more pronounced indirect signs, a higher proportion of critically ill patients, and longer hospital stays (all P<0.001). Recurrent pancreatitis was more common in the PPH group. Differences in the remaining indicators were not statistically significant.Conclusion: Analysis of clinical and imaging findings provided clinically significant for assessing the severity of splenic vein involvement or PPH in acute pancreatitis.
Keywords
tomography, x-ray computer, acute pancreatitis, pancreatic portal hypertension
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[2] Patel RK, Tripathy T, Chandel K, et al. Left-sided portal hypertension: what an interventional radiologist can offer? Eur Radiol, 2025; 35(5): 2530-2542.
[3] Yu C, Ding L, Jiang M, et al. Dynamic Changes and Nomogram Prediction for Sinistral Portal Hypertension in Moderate and Severe Acute Pancreatitis. Front Med (Lausanne), 2022; 9: 875263.
[4] Zhang Y, Su Q, Li Y, et al. Development of a nomogram for predicting pancreatic portal hypertension in patients with acute pancreatitis: a retrospective study. BMJ Open Gastroenterol, 2024; 11(1).
[5] Zhao X, Mao TY, Jiang KY, et al. Analysis of risk factors for acute pancreatitis complicated with pancreatic sinistral portal hypertension and construction of predictive model. Front Physiol, 2023; 14: 1256615.
[6] Easler J, Muddana V, Furlan A, et al. Portosplenomesenteric venous thrombosis in patients with acute pancreatitis is associated with pancreatic necrosis and usually has a benign course. Clin Gastroenterol Hepatol, 2014; 12(5): 854-862.
[7] Ahmed SU, Rana SS, Ahluwalia J, et al. Role of thrombophilia in splanchnic venous thrombosis in acute pancreatitis. Ann Gastroenterol, 2018; 31(3): 371-378.
[8] Li H, Yang Z, Tian F. Clinical Characteristics and Risk Factors for Sinistral Portal Hypertension Associated with Moderate and Severe Acute Pancreatitis: A Seven-Year Single-Center Retrospective Study. Med Sci Monit, 2019; 25: 5969-5976.
[9] Ru N, He CH, Ren XL, et al. Risk factors for sinistral portal hypertension and related variceal bleeding in patients with chronic pancreatitis. J Dig Dis, 2020; 21(8): 468-474.
[10] Colvin SD, Smith EN, Morgan DE, et al. Acute pancreatitis: an update on the revised Atlanta classification. Abdom Radiol (NY), 2020; 45(5): 1222-1231.
[11] Marn CS, Glazer GM, Williams DM, et al. CT-angiographic correlation of collateral venous pathways in isolated splenic vein occlusion: new observations. Radiology, 1990; 175(2): 375-380.
[12] Xie CL, Wu CQ, Chen Y, et al. Sinistral Portal Hypertension in Acute Pancreatitis: A Magnetic Resonance Imaging Study. Pancreas, 2019; 48(2): 187-192.
[13] Liu J, Wang Q, Ding X, et al. The clinical applicability of percutaneous splenic vein stent implantation for pancreatic portal hypertension. BMC Gastroenterol, 2022; 22(1): 136.
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