LAUSR

Unusual site venous thrombosis (USVT), which includes venous thromboses of the upper limbs, digestive tract, cellar and brain, are rarely observed compared to those of the lower limbs and require both an etiological approach and a rigorous management.Our objective is to identify the epidemiological, clinical, therapeutic and evolutionary characteristics of USVT.Retrospective study including 33 patients files with USVT followed in The Internal Medicine Departments at Tahar Sfar University Hospital Mahdia TUNISIA over a period of 10 years.They were 21 females (63.6 %) and 12 males (36.4%) with an average age of 45.2 ± 18 years. Cerebral venous thrombosis was the most frequent localization identified in 10 patients (30.3%), followed by gastrointestinal thrombosis in 9 cases (27.3%), vena cava thrombosis in 9 cases (27.3%) and upper limb thrombosis in 5 cases (15.2%). The risk factors were respectively: age (42.4%), obesity (42.4%), smoking (30%), prolonged downtime (24.2%), surgical interventions (6.1%) and pregnancy (3%). An etiology was identified in 21 patients (66.6%), dominated by constitutional thrombophilia (27.3%), followed by BVL (15.1%) and Behçet’s disease (16.4%). Rare causes were neoplasia in one case (3%), scleroderma in one case (3%) and inflammatory bowel disease in one case (3%). The etiological investigation was negative in 36.3% of cases. Treatment was based on heparin therapy followed by vitamin K therapy. Progression was favourable without accident or recurrence in 25 patients (75.5%). Complications were dominated by recurrence in 12.1% of cases, post-thrombotic disease in 6% of cases and pulmonary embolism in 3% of cases. We reported one death related to a hemorrhagic event.USVT is a multifactorial pathology that involves both acquired and constitutional risk factors. Heparin therapy with an early relay by antivitamin K remains the treatment of choice today. The duration of treatment depend on the etiology, the recurrence of venous thrombosis and the risk of hemorrhagic complications.None declared