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[Mesenteric-portal thrombosis after hematologic splenectomy]

N Kunin1, J F Desjardins, J P Letoquart

  • 1Service de Chirurgie Générale A, C.H.R. Rennes, Hôpital Sud.

Journal De Chirurgie
|January 1, 1996
PubMed
Summary

Portal system venous thrombosis is a rare but serious complication after splenectomy for hematological diseases. Early diagnosis and treatment, including anticoagulation or surgery, are crucial for favorable outcomes.

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Area of Science:

  • Medical Sciences
  • Hematology
  • Gastroenterology

Background:

  • Splenectomy is performed for various hematological conditions.
  • Portal system venous thrombosis is an uncommon but significant post-splenectomy complication.
  • Incidence ranges from 0.2% to 6%, with variable clinical presentations and diagnostic challenges.

Observation:

  • This study presents four cases of PVT following splenectomy for hematological diseases.
  • Clinical presentations varied, including abdominal pain, hepatic failure, asthenia, and fever.
  • Diagnostic methods included coeliac arteriography, Doppler ultrasonography, and CT-scan.

Findings:

  • PVT was diagnosed in 4 out of 355 splenectomies (1.1%).
  • Case 1 involved small bowel necrosis requiring resection.

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  • Cases 2 and 3 were treated with heparin, while Case 4 underwent thrombectomy and thrombolysis.

    • Implications:

    • PVT post-splenectomy requires a high index of suspicion due to diverse clinical presentations.
    • Timely diagnosis and appropriate management, including anticoagulation and surgical interventions, are vital.
    • Further research into prophylactic strategies may be warranted.