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Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes.

Publication ,  Journal Article
Antiel, RM; Hashim, Y; Moir, CR; Rodriguez, V; Elraiyah, T; Zarroug, AE
Published in: J Pediatr Surg
April 2014

PURPOSE: Children with chronic ulcerative colitis (CUC) are at increased risk for venous thromboembolism, especially after colectomy procedures. We aim to review our patients with CUC who underwent a colectomy and suffered intra-abdominal thrombosis; moreover we wanted to define thrombotic incidence and outcomes METHODS: In this is IRB approved retrospective study, we reviewed our patients who underwent colectomy for CUC from January 1999 to December 2011 for development of intra-abdominal thrombosis. RESULTS: Of 366 patients with CUC who underwent colectomy, 15 (4%) were diagnosed with a venous thromboembolism. All patients presented with acute abdominal pain. The locations of thrombus formation varied: 13 (87%) developed thrombi in the portal vein, 4 (27%) in the splenic vein, 2 (13%) in the superior mesenteric vein, 1 (7%) in the hepatic vein, and 1 (7%) in the hepatic artery. The mean number of post-operative days at diagnosis of thrombus was 38.7 days (range 3-180 days). Fourteen patients (93%) underwent anticoagulation for treatment. The mean number of days of anticoagulant therapy until documented resolution of thrombus on imaging was 96.3 days (range 14-364 days). All thrombi resolved with therapy. There was no mortality during follow-up. CONCLUSIONS: Four percent of our pediatric patients with chronic ulcerative colitis who underwent colectomy developed symptomatic intra-abdominal venous thromboembolism. 3 to 6 months of anticoagulant therapy is adequate treatment in almost all patients. Practitioners should have a high index of suspicion for intra-abdominal venous thrombus when these patients complain of abdominal pain postoperatively. Based on our experience, prophylactic anticoagulation should be strongly considered peri-operatively in this population.

Duke Scholars

Published In

J Pediatr Surg

DOI

EISSN

1531-5037

Publication Date

April 2014

Volume

49

Issue

4

Start / End Page

614 / 617

Location

United States

Related Subject Headings

  • Young Adult
  • Venous Thrombosis
  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Pediatrics
  • Male
  • Incidence
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Antiel, R. M., Hashim, Y., Moir, C. R., Rodriguez, V., Elraiyah, T., & Zarroug, A. E. (2014). Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes. J Pediatr Surg, 49(4), 614–617. https://doi.org/10.1016/j.jpedsurg.2013.10.004
Antiel, Ryan M., Yassar Hashim, Christopher R. Moir, Vilmarie Rodriguez, Tarig Elraiyah, and Abdalla E. Zarroug. “Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes.J Pediatr Surg 49, no. 4 (April 2014): 614–17. https://doi.org/10.1016/j.jpedsurg.2013.10.004.
Antiel RM, Hashim Y, Moir CR, Rodriguez V, Elraiyah T, Zarroug AE. Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes. J Pediatr Surg. 2014 Apr;49(4):614–7.
Antiel, Ryan M., et al. “Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes.J Pediatr Surg, vol. 49, no. 4, Apr. 2014, pp. 614–17. Pubmed, doi:10.1016/j.jpedsurg.2013.10.004.
Antiel RM, Hashim Y, Moir CR, Rodriguez V, Elraiyah T, Zarroug AE. Intra-abdominal venous thrombosis after colectomy in pediatric patients with chronic ulcerative colitis: incidence, treatment, and outcomes. J Pediatr Surg. 2014 Apr;49(4):614–617.
Journal cover image

Published In

J Pediatr Surg

DOI

EISSN

1531-5037

Publication Date

April 2014

Volume

49

Issue

4

Start / End Page

614 / 617

Location

United States

Related Subject Headings

  • Young Adult
  • Venous Thrombosis
  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Pediatrics
  • Male
  • Incidence
  • Humans
  • Female