Successful Treatment of Splenic Vein Thrombosis Secondary to Acute Pancreatitis with Oral Anticoagulants: A Pediatric Case Series.

Document Type

Article

Publication Date

11-25-2022

Identifier

DOI: 10.12659/AJCR.937599

Abstract

BACKGROUND Two Pediatric Patients with Splanchnic Venous Thrombosis as a Complication of Acute Pancreatitis Successfully Treated with Low-Molecular-Weight Heparin and Rivaroxaban CASE REPORT Case 1: A 13-year-old girl presented with a second attack of acute pancreatitis. She developed a non-occlusive splenic vein thrombosis diagnosed by CT scan on the sixth day of hospitalization. Injectable low-molecular-weight heparin was started during hospitalization and switched to oral rivaroxaban at discharge. Imaging at follow-up showed resolution of thrombosis. Case 2: A 9-year-old girl with history of acute recurrent pancreatitis presented with a third attack of acute pancreatitis. An occlusive splenic vein thrombosis with extension into the portal vein and superior mesenteric vein and necrotizing pancreatitis was seen on CT scan on the third day of hospitalization. Low-molecular-weight heparin was initiated during hospitalization and was switched to oral rivaroxaban at discharge. Imaging at follow-up demonstrated nearly complete resolution of the extensive thrombosis. CONCLUSIONS Splanchnic venous thrombosis remains a rare complication of pediatric pancreatitis. Anticoagulant use in patients with these complications remains controversial. Direct oral anticoagulants are as safe and effective as low-molecular-weight heparin and should be considered for use in children instead of low-molecular-weight heparin due to its advantages, including the availability of enteral forms of administration.

Journal Title

Am J Case Rep

Volume

23

First Page

937599

Last Page

937599

MeSH Keywords

Female; Humans; Child; Adolescent; Splenic Vein; Pancreatitis; Rivaroxaban; Acute Disease; Venous Thrombosis; Anticoagulants; Thrombosis; Heparin, Low-Molecular-Weight

Keywords

Splenic Vein; Pancreatitis; Rivaroxaban; Acute Disease; Venous Thrombosis; Anticoagulants; Thrombosis; Low-Molecular-Weight Heparin

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