Extensive porto-splenic venous thrombosis postsplenectomy in a sickle cell disease: a rare complication

Abstract

Hereditary haemoglobinopathies are common disorders in Oman. The most common haematological disorder among Omani population is sickle cell disease (SCD). The spleen is one of the organs that is affected early in the first decade of life in SCD patients. Splenectomy has shown a high success rate in improving the quality of life in SCD patients, through eliminating acute splenic sequestration crises, thus reducing the need for hospital admission and transfusion requirements. One of the rare complications of splenectomy is porto-splenic vein thrombosis. Multiple factors are responsible for this complication including: thermal and mechanical injury during ligation of splenic hilum, sudden increase in the platelet count and large spleen size. We report a rare case of extensive porto-splenic vein thrombosis that responded to early initiation of anticoagulation with resolution of the thrombosis and recanalisation.

Intravascular hemolysis and multitreatment predict thrombosis in patients with autoimmune hemolytic anemia

“…18 Other predisposing conditions included Such microparticles are enriched in procoagulant mediators and phosphatidyl serine and may further favor thrombotic episodes. 20 Although splenectomy is a recognized risk factor for thrombosis in various conditions, [21][22][23][24][25] here we found only a slightly higher frequency of thrombosis in splenectomized patients. This may be due to the low number and progressive decrease of splenectomy over time, and to the higher awareness of splenectomy-related thrombotic risk.…”