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Portal vein thrombosis after splenectomy
Emily R Winslow1, L Michael Brunt, Jeffery A Drebin
1Department of Surgery, Washington University School of Medicine, 660 South Euclid, Campus Box 8109, St. Louis, MO 63110, USA. winslowe@msnotes.wustl.edu
American Journal of Surgery
|December 19, 2002
Summary
Portal vein thrombosis (PVT) is a common postsplenectomy complication in patients with splenomegaly. Early diagnosis via CT scan and prompt anticoagulation are crucial for successful outcomes.
Area of Science:
- Abdominal Surgery
- Vascular Surgery
- Gastroenterology
Background:
- Portal vein thrombosis (PVT) is a known complication after splenectomy.
- Factors influencing PVT development and clinical outcomes post-splenectomy require further characterization.
Purpose of the Study:
- To identify factors associated with postsplenectomy PVT.
- To characterize the clinical outcomes of patients who develop PVT after splenectomy.
Main Methods:
- Retrospective review of case logs from four surgeons between 1996 and 2001.
- Identification of patients who developed PVT following splenectomy.
Main Results:
- Eight cases (8%) of PVT were identified among 101 splenectomies.
- PVT occurred in patients with myeloproliferative disease, hemolytic anemia, and myelodysplastic disorder, all with splenomegaly.
- High spleen weight (>3,000g) in myeloproliferative disease patients increased PVT risk (75%).
Conclusions:
- PVT is a relatively common postsplenectomy complication in patients with splenomegaly.
- Early diagnosis using contrast-enhanced computed tomography (CT) is essential.
- Prompt anticoagulation therapy is critical for successful patient outcomes.