The clinical complexity of splenic vein thrombosis.

Abstract

Upper gastrointestinal hemorrhage secondary to splenic vein thrombosis is a curable form of localized portal hypertension when treated with splenectomy. A high index of suspicion is necessary in order to promptly diagnose and treat this underrecognized condition that is most commonly caused by inflammation or neoplasm of the pancreas. The triad of isolated gastric varices, splenomegaly, and normal hepatic function is classic; it is not uncommon, however, for patients to have only some or even none of these conditions. Mesenteric angiography with venous phase imaging is the gold standard of diagnosis. Ultrasound and CT may identify splenic vein thrombosis, but are most helpful in delineating concomitant upper abdominal pathology. Early recognition and intervention allow associated underlying conditions to be treated under the same anesthetic with minimal morbidity and mortality.

• Authors: D C Han, D V Feliciano
• Journal: The American surgeon (Am Surg) Vol. 64 Issue 6 Pg. 558-61; discussion 561-2 (Jun 1998) ISSN: 0003-1348 [Print] United States
• PMID: 9619178 (Publication Type: Journal Article)

Topics

• Adenocarcinoma (complications, diagnosis, mortality)
• Adult
• Diagnosis, Differential
• Diagnostic Imaging
• Female
• Gastrointestinal Hemorrhage (etiology, mortality, surgery)
• Humans
• Hypertension, Portal (diagnosis, mortality, surgery)
• Male
• Middle Aged
• Pancreatic Neoplasms (complications, diagnosis, mortality)
• Prognosis
• Recurrence
• Retrospective Studies
• Splenectomy
• Splenic Vein
• Survival Rate
• Thrombosis (diagnosis, mortality, surgery)
• Treatment Outcome