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Portal vein thrombosis following splenectomy
Hassn1, Al-Fallouji, Ouf
1Pilgrim Hospital, Boston, UK and Ain-Shams University Hospital, Egypt.
The British Journal of Surgery
|March 16, 2000
Summary
Splenectomy increases portal vein thrombosis risk by 10%, but this complication is treatable. Portal vein thrombosis (PVT) after splenectomy shows high recanalization rates with anticoagulation therapy.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Hepatology
Background:
- Portal vein thrombosis (PVT) is a potential complication following abdominal surgery.
- The specific risk and natural progression of PVT after splenectomy require further investigation.
Purpose of the Study:
- To evaluate the incidence and clinical course of portal vein thrombosis (PVT) subsequent to splenectomy.
- To compare the risk of PVT in patients undergoing splenectomy versus other upper abdominal surgeries.
Main Methods:
- A prospective study comparing 50 splenectomy patients with 50 undergoing other upper abdominal surgeries.
- Duplex Doppler ultrasonography (DDUS) was used for portal system assessment pre-operatively and at 2 weeks post-operatively.
- Patients diagnosed with PVT were followed up with DDUS at 6 and 12 months.
Main Results:
- Portal vein thrombosis (PVT) occurred in 10% of patients post-splenectomy (4% complete, 6% partial occlusion).
- Eighty percent of patients with PVT experienced symptoms like abdominal pain and nausea.
- No PVT was observed in the control group undergoing different upper abdominal surgeries.
Conclusions:
- Splenectomy is associated with a 10% risk of developing portal vein thrombosis (PVT).
- PVT following splenectomy demonstrates successful treatment outcomes with antibiotics and anticoagulation, achieving significant recanalization.
- Non-splenectomy upper abdominal surgery does not appear to carry a significant risk for PVT.