Isolated splenic vein thrombosis.

Area of Science:

• Gastroenterology
• Vascular Surgery
• Radiology

Background:

• Splenic vein thrombosis (SVT) can present with isolated gastric varices, splenomegaly, and normal liver function.
• Pancreatic disease is the most common etiology of SVT.
• Gastric varices associated with SVT can be challenging to diagnose.

Purpose of the Study:

• To highlight the clinical presentation of isolated splenic vein thrombosis.
• To emphasize the diagnostic and therapeutic role of angiography and splenectomy.

Main Methods:

• Review of clinical presentations and diagnostic findings in patients with SVT.
• Discussion of the utility of angiography in evaluating SVT and associated portal venous thrombosis.
• Analysis of treatment outcomes for splenectomy in managing variceal hemorrhage.

Main Results:

• Isolated SVT can lead to bleeding from difficult-to-diagnose gastric varices.
• Angiography is essential to rule out concurrent portal venous thrombosis before splenectomy.
• Splenectomy is a curative treatment for variceal hemorrhage secondary to SVT.

Conclusions:

• Splenic vein thrombosis requires careful diagnostic evaluation, including angiography.
• Splenectomy should be considered for managing symptomatic gastric varices caused by SVT, particularly after hemorrhage occurs.
• The natural history of asymptomatic SVT remains uncertain, but intervention is typically reserved for symptomatic cases.