Splanchnic vein thrombosis

Splanchnic vein thrombosis (SVT) – including mesenteric, portal, splenic and supra-hepatic veins thrombosis – is an underdiagnosed disease, with heterogeneous clinical presentations and a non-negligible rate of incidental findings. The main risk factors include abdominal diseases or interventions (e.g. infections, cirrhosis, abdominal cancer or surgical procedures), haematological disorders (mainly myeloproliferative neoplasms), inherited thrombophilic states and hormonal imbalances. New biological markers of subclinical disorders have recently been identified: JAK2 mutation and flow cytometry for CD55 and CD59. Clinical manifestations are generally aspecific. During the acute phase, main symptoms can be abdominal pain, gastrointestinal bleeding and ascites; while long-term consequences include liver cirrhosis and portal hypertension. Advances in non-invasive vascular imaging (Doppler ultrasound, angio-computed tomography and magnetic resonance imaging), have improved the diagnosis of SVT. Alterations in blood tests may suggest an underlying haematological or hepatic disorder.