ORIGINAL ARTICLE Risk Factors of Portal Vein Thrombosis in Crohn’ s Disease Patients Galen G. Leung & Muthu V. Sivasankaran & Jacqueline J. Choi & Celia M. Divino Received: 17 November 2011 / Accepted: 20 February 2012 / Published online: 29 March 2012 # 2012 The Society for Surgery of the Alimentary Tract Abstract Introduction Patients with inflammatory bowel disease, such as Crohn’ s disease (CD), suffer from a threefold increase in the risk of venous thromboembolism. Small bowel, segmental bowel, or ileocolonic resection to treat Crohn’ s disease can lead to rare complications of portal vein thrombosis (PVT), which can lead to further poor health outcomes, such as small bowel ischemia. The study attempts to find different risk factors that may be associated with postoperative complications of PVT in Crohn’ s disease patients. Methods In a 1 to 3 case–control study following Institutional Review Board approval, 13 Crohn’ s disease patients with documented radiological postoperative diagnosis of PVT from 2004 to 2011 and 39 CD patients who did not have postoperative PVT were matched by retrospective chart review for patient demographics, preoperative course and workup, anticoagulant use, and operative procedure. Univariate analysis was performed to draw correlations on risk factors for the development of PVT. Results In the 13 CD patients with PVT, concurrent cancer, liver disease, and dyslipidemia were present in 23.1%, 23.1%, and 15.4% of the population, respectively. Compared to the 39 CD only patients, concurrent cancer, liver disease, and dyslipidemia were present in only 2.6%, 2.6%, and 0% of the population, respectively. Of the CD patients with PVT, 61.5% were on preoperative steroids compared to 28.9% of the CD only patients. PVT development in CD patients is correlated with concurrent cancer (p 0 0.016), liver disease (p 0 0.016), dyslipidemia (p 0 0.012), and preoperative steroid usage (p 0 0.036). Conclusions Concurrent cancer, liver disease, dyslipidemia, and preoperative steroid usage were risk factors associated with the development of PVT in Crohn’ s patients. Since there is limited literature on PVT in CD, more data needs to be collected, and additional studies should be done to further assess the prevention, diagnosis, and management of the disease. Keywords Portal Vein thrombosis . Risk Factors . Crohn’ s disease . Venous thromboembolism . Post-operative complications in Crohn’ s disease Introduction Patients with inflammatory bowel disease, such as Crohn’ s disease, suffer from a threefold increase in the risk of venous thromboembolism. 1 Patients with thromboembolitic complica- tions have mortality rates as high as 25%. 2 The incidence of portal vein thrombosis is higher following abdominal surgery, 3 with 6% of IBD patients developing portal vein thrombosis after restorative protocolectomy. 13 Portal vein thrombosis (PVT) can lead to life-threatening small bowel ischemia and portal vein hypertension. This study attempts to find different risk factors that may be associated with postoperative compli- cations of PVT in Crohn’ s disease patients. Abstract was presented at American College of Surgeons–Medical Student Poster Presentation October 24, 2011 in San Francisco, CA, USA. G. G. Leung : M. V. Sivasankaran : J. J. Choi : C. M. Divino (*) Division of General Surgery, Department of Surgery, Mount Sinai School of Medicine, 5 E. 98th Street, 15th Floor, Box 1259, New York, NY 10029, USA e-mail: celia.divino@mountsinai.org J Gastrointest Surg (2012) 16:1199–1203 DOI 10.1007/s11605-012-1854-1