Incidence of Splanchnic Venous Thrombosis in Acute Pancreatitis and it's Correlation With Severity of Pancreatitis

Incidence of Splanchnic Venous Thrombosis in Acute Pancreatitis and it's Correlation With Severity of Pancreatitis - a Prospective Observational Study

Acute pancreatitis (AP) is a common medical condition characterized by inflammation of the pancreas, affecting a significant portion of the population. With approximately one-third of patients experiencing notable morbidity due to local or systemic complications, the severity of the disease is underscored by the presence of acute peripancreatic fluid collections, acute necrotic collections, pseudocysts, and walled-off necrosis1. Notably, vascular complications, such as splanchnic vein thrombosis, further contribute to the increased morbidity and mortality associated with acute pancreatitis2. Splanchnic vein thrombosis encompasses thromboses in the splenic (SpVT), portal (PVT), and superior mesenteric veins (SMVT), either individually or in combination3. These complications are often incidentally discovered during imaging procedures conducted to assess potential complications4. Despite most cases being asymptomatic, fatal complications, including bowel ischemia, liver failure, portal hypertension, and life-threatening bleeding, have been documented, with the risk of splanchnic vein thrombosis escalating with the severity of pancreatitis

Study Overview

• Status: Recruiting
• Conditions: Acute Pancreatitis

Detailed Description

Acute pancreatitis (AP) is a common medical condition characterized by inflammation of the pancreas, affecting a significant portion of the population. With approximately one-third of patients experiencing notable morbidity due to local or systemic complications, the severity of the disease is underscored by the presence of acute peripancreatic fluid collections, acute necrotic collections, pseudocysts, and walled-off necrosis1. Notably, vascular complications, such as splanchnic vein thrombosis, further contribute to the increased morbidity and mortality associated with acute pancreatitis2. Splanchnic vein thrombosis encompasses thromboses in the splenic (SpVT), portal (PVT), and superior mesenteric veins (SMVT), either individually or in combination3. These complications are often incidentally discovered during imaging procedures conducted to assess potential complications4. Despite most cases being asymptomatic, fatal complications, including bowel ischemia, liver failure, portal hypertension, and life-threatening bleeding, have been documented, with the risk of splanchnic vein thrombosis escalating with the severity of pancreatitis.

The intricate relationship between the pancreas and large mesenteric vessels, coupled with systemic inflammatory responses, hypovolemia, fluid shifts, and prothrombotic states, contributes to the development of splanchnic vein thrombosis in acute pancreatitis5. Early detection of these thrombotic events becomes imperative to mitigate long-term sequelae such as portal hypertension and chronic mesenteric ischemia6. Despite the critical importance of identifying splanchnic vein thrombosis in acute pancreatitis, there is a notable absence of standardized recommendations for initiating anticoagulation treatment in these cases5. The decision-making process is further complicated by the potential risk of bleeding associated with other vascular complications, such as bleeding into pseudocysts or pseudo-aneurysmal bleeds7. As a result, there is a pressing need for more comprehensive studies that delve into the risk factors, pathogenesis, therapeutic impacts, and outcome predictors associated with splanchnic vein thrombosis in the context of acute pancreatitis. These investigations will not only enhance our understanding of the condition but also inform the development of evidence-based guidelines for the management of splanchnic vein thrombosis in individuals with acute pancreatitis.

• Study Type: Observational
• Enrollment (Estimated): 500

Contacts and Locations

• Study Contact: Name: Sharath Sitaram, MBBS, DNB; Phone Number: 8197016905; Email: sharath.sitaram@gmail.com

Study Locations

• India
  • Telangana
    • Hyderabad, Telangana, India, 500032
      • Recruiting
      • AIG hospital
      • Contact: Dr. Sharath Sitaram, DrNB; Phone Number: +91 8197016905; Email: sharath.sitaram@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

All in-patients with acute pancreatitis, getting admitted from emergency or OPD will be enrolled. Only when a study subject has given informed consent, clinical data will be recorded

Description

Inclusion Criteria:

• Patients aged between 18-85 years of age.
• Diagnosis of AP as per international consensus criteria.

Exclusion Criteria:

• Chronic pancreatitis.
• Established malignancy.
• Cirrhosis of liver or established portal hypertension.
• Pregnancy.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary outcome	Detection of thrombus in splenic, superior mesenteric or portal vein.	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Secondary Outcome	Correlation of splanchnic venous thrombosis with severity of acute pancreatitis.	1 year
Secondary Outcome	Incidence of infected pancreatic necrosis/ peri-pancreatic fluid collections in patients with acute pancreatitis having SVT.	1 year
Secondary Outcome	Effect of drainage of peripancreatic fluid collections/ necrotic collections on status of thrombosis.	1 year
Secondary Outcome	Vessel recanalization on follow-up at 6 months	6 months

Collaborators and Investigators

• Sponsor: Asian Institute of Gastroenterology, India

Study record dates

Study Major Dates

• Study Start (Actual): February 27, 2025
• Primary Completion (Estimated): February 27, 2026
• Study Completion (Estimated): February 27, 2026

Study Registration Dates

• First Submitted: April 2, 2025
• First Submitted That Met QC Criteria: December 30, 2025
• First Posted (Actual): January 7, 2026

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: December 30, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Pancreatic Diseases; Pancreatitis
• Other Study ID Numbers: SVT in AP-01

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No