FEYZULLAH UÇMAK, Nazım EKİN, Elif Tuğba TUNCEL, Kendal YALÇIN

Siroz ve tümör dışı portal ven trombozu; risk faktörleri, klinik ve laboratuvar özellikleri

Giriş ve Amaç: Kliniğimizde tanı alan siroz ve tümör dışı portal ven trombozlu hastalarımızın etiyolojik, klinik ve laboratuvar özelliklerini sunmaktır. Gereç ve Yöntem: Dicle Üniversitesi Tıp Fakültesi Gastroen- teroloji Kliniğine Mayıs 2010- Ağustos 2011 tarihleri arasında başvuran, siroz ve tümör tanısı dışlanmış portal ven trombozlu 25 hasta retros- pektif olarak incelendi. Hasta kayıtları demografik özellikler, başvuru semptomları, laboratuvar, radyolojik ve endoskopik özellikleri açısından tarandı. Bulgular: Olgularımızın 16'sı kadın, 9'u erkek olup ortalama yaş 39,4±13,1 idi. En sık başvuru yakınması karın ağrısı (%44) olup en sık rastlanan fizik muayene bulgusu splenomegali (%76) idi. On hastamızda majör etiyolojik faktör saptandı. Bir hastada iki, bir hastada ise üç etiyolojik faktör birlikte mevcuttu. Olguların %32'sinde metiltet- rahidrofolat redüktaz gen mutasyonu (1 hastada homozigot, 7 hastada heterozigot), %16'sında gebelik/postpartum dönem, %12'sinde sple- nektomi öyküsü, %8'inde polisitemia rubra vera, %8'inde myelofibrozis ve %4'ünde JAK-2 gen mutasyonu saptanmıştır. Üç olgumuz akut, 22 olgumuz kronik portal ven trombozu tanısı almıştır. Sonuç: Portal ven trombozu tanılı hastalarımızda en sık görülen etiyolojik faktörlerin, kro- nik myeloproliferatif hastalıklar ve gebelik olduğu saptandı. Portal ven trombozunda etiyolojik faktörün saptanması tedavi planı ve progresyo- nun önlenmesi açısından önemlidir

Non-cirrhotic non-tumoral portal vein thrombosis: risk factors, clinical and laboratory manifestations

Background and Aims: The purpose of this study was to present eti- ological, clinical and laboratory manifestations in patients diagnosed with non-cirrhotic non-tumoral portal vein thrombosis in our clinic. Ma- terials and Method: A total of 25 patients who had been diagnosed with non-cirrhotic non-tumoral portal vein thrombosis in the Gastro- enterology Clinic of Dicle University Faculty of Medicine between May 2010 and August 2011 were examined in this study retrospectively. Demographic data, presenting symptoms and laboratory, radiological and endoscopic manifestations were noted. Results: Of 25 patients with a mean age of 39.4±13.1 years (ranging from 17 to 71), 16 were female and 9 were male. The most common presenting symptom was abdominal pain (44%), and the most common physical examination finding was splenomegaly (76%) among these patients. Ten patients exhibited some kind of major etiological factor -one patient exhibited two factors and another patient exhibited three factors concurrently. In addition, 32% of the patients had methylenetetrahydrofolate reduc- tase gene mutation (homozygous state in 1 patient and heterozygous state in 7 patients). Sixteen percent of the study population was com- prised of postpartum patients, 12% had a history of splenectomy, 8% had polycythemia rubra vera, 8% had myelofibrosis and 4% had JAK-2 gene mutation. Three patients were diagnosed with acute portal vein thrombosis and 22 patients were diagnosed with chronic portal vein thrombosis. Conclusion: The most common etiological factors identi- fied in our patients were myeloproliferative diseases and pregnancy. In this respect, determination of the etiological factor underlying portal vein thrombosis is of importance both for halting the progression and planning the treatment

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