Portal system thrombosis: a complication of long-term residence at extreme altitude.
Article
in English
| IMSEAR
| ID: sea-65408
ABSTRACT
BACKGROUND:
With induction of the Indian Army to heights over 5,000 meters above sea level, complications of long-term stay at extreme altitude have come to light. We describe our experience with patients developing portal system thrombosis.METHODS:
Clinical data were collected over 2 years on patients hospitalized for thrombotic complications from high-altitude (HAA) and non-high altitude (non-HAA) areas. Site of thrombosis was confirmed by imaging or at surgery. Patients were investigated for conditions that predispose to venous thrombosis.RESULTS:
Ten cases of portal system thrombosis were seen during the period; of these, 9 (mean age 28 [SD 3.9] years; all men) were from HAA. Mean duration of residence in HAA was 12.4 (4.9) months; two were smokers and six drank 7-22 g alcohol/day at least 5 times a week. The first symptom was abdominal pain; this was later complicated by gastrointestinal bleeding (n=5), fever (7), vomiting (7), and weight loss (5). Average time between onset of first symptom and reaching a tertiary-care hospital was 9.5 (4.7) days. Clinical examination showed ascites (8 cases), splenomegaly (7), and hepatomegaly (6). Mean hemoglobin level at admission was 15.8 (3.4) g/dL. Ascites was hemorrhagic; five cases also had large splenic hematoma. The site of thrombosis was splenic vein (7 cases), portal vein (6), and superior (4) and inferior (1) mesenteric vein. None of 5 patients investigated had any prothrombotic condition. Endoscopic/ sonographic evidence of development of collaterals appeared as early as 12-20 days after onset of symptoms.CONCLUSION:
Residence in HAA for extended periods is a risk factor for development of portal system thrombosis. Persistent pain in abdomen in such individuals should raise the possibility of portal system thrombosis.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Reference Values
/
Time Factors
/
Humans
/
Male
/
Tomography, X-Ray Computed
/
Case-Control Studies
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Incidence
/
Prospective Studies
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Ultrasonography, Doppler
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Risk Assessment
Type of study:
Etiology study
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Incidence study
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Observational study
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Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Year:
2001
Type:
Article
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