Splenic Vein Thrombosis: Case Report

Isolated splenic vein thrombosis is being recognized more frequently as a complication of pancreatic disease and as the cause of gastrointestinal hemorrhage in patients without liver disease. The increased incidence reflects advances in diagnostic radiology and a higher index of suspicion for the diagnosis. Splenic vein thrombosis should be suspected in: (a) a patient with a history of pancreatitis and gastrointestinal blood loss; (b) a patient with splenomegaly in the absence of portal hypertension, cirrhosis, or hematologic disease; and (c) in the setting of isolated gastric varices. Celiac angiography has replaced splenoportography as the definitive diagnostic tool for splenic vein thrombosis and is indicated prior to operation for suspected portal hypertension or for complications of pancreatitis. The importance of making the diagnosis lies in differentiating the lesion from the more common case of hepatic and extrahepatic portal hypertension. The treatment of choice is splenectomy.

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Isolated splenic vein thrombosis

Moossa

1985

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Segmental Portal Hypertension

1986

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Isolated obstruction of the splenic vein leads to segmental portal hypertension, which is a rare form of extrahepatic portal hypertension, but it is important to diagnose, since it can be cured by splenectomy. In a review of the English literature, 209 patients with isolated splenic vein obstruction were found. Pancreatitis caused 65% of the cases and pancreatic neoplasms 18%, whereas the rest was caused by various other diseases. Seventy-two per cent of the patients bled from gastroesophageal varices, and most often the bleeding came from isolated gastric varices. The spleen was enlarged in 71% of the patients. A correct diagnosis in connection with the first episode of bleeding was made in only 49%; 22% were operated on because of gastrointestinal bleeding, but the cause of bleeding was not found. The diagnosis should be suspected in patients with gastroesophageal varices, but without signs of a liver disease, especially if isolated gastric varices are found. The diagnosis is confirmed by portography.

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Splenic Vein Thrombosis: Case Report

Cited by 2 publications

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Isolated splenic vein thrombosis

Isolated splenic vein thrombosis

Segmental Portal Hypertension

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