Document Detail


Portal vein thrombosis following splenectomy: identification of risk factors.
MedLine Citation:
PMID:  14627254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Portal vein thrombosis (PVT) following splenectomy is a potentially life-threatening complication, and the true incidence of PVT in splenectomized patients is unknown. The objective of this study was to determine the incidence of symptomatic PVT after splenectomy. The hospital database was searched to identify cases of PVT associated with splenectomy from January 1990 to May 2002. Six hundred eighty-eight patients underwent splenectomy during this period, 321 of them for hematologic diseases. Eleven of the 688 patients had PVT associated with splenectomy, and the charts of these patients were reviewed. Six patients developed PVT after splenectomy. Five had hematologic diseases. Symptoms were abdominal pain (6), ileus (5), fever (3), or diarrhea (2). Diagnosis was confirmed by computed tomography (CT) (4), duplex ultrasonography (1), and magnetic resonance imaging (1). The indications for splenectomy included hemolytic anemia (3), thalassemia (1), and myelofibrosis (1). One patient had an incidental splenectomy during gastrectomy. There were four laparoscopic and two open splenectomies. The median interval between splenectomy and diagnosis of PVT was 40 days (range, 13-741). One patient died of pulmonary embolism. Five of six patients with postsplenectomy PVT had splenomegaly and hemolysis. We conclude that the risk of PVT is higher in patients with hematologic conditions associated with splenomegaly and hemolysis.
Authors:
Fumihiko Fujita; Sergey Lyass; Koji Otsuka; Luca Giordano; David L Rosenbaum; Theodore M Khalili; Edward H Phillips
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  69     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-20     Completed Date:  2003-12-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  951-6     Citation Subset:  IM    
Affiliation:
Center for Minimally Invasive Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Hematologic Diseases / surgery
Humans
Male
Middle Aged
Portal Vein*
Risk Factors
Splenectomy / adverse effects*
Tomography, X-Ray Computed
Venous Thrombosis / diagnosis,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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