Document Detail


Right heart and pulmonary thromboembolism from extensive splanchnic vein thrombosis after splenectomy for myeloproliferative disease.
MedLine Citation:
PMID:  21684598     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Splenectomy is a risk factor for both portal-vein and chronic thromboembolic pulmonary hypertension. The underlying mechanism is unclear, but may involve a hypercoagulable state. METHODS: We describe 1 patient with polycythemia vera who developed extensive portal thrombosis of the portal, suprahepatic, and inferior cava veins, leading to right heart thromboembolism, with a resultant pulmonary embolism subsequent to splenectomy despite heparin prophylaxis. RESULTS: In this patient, several mechanisms may have played a role, including perioperative stress, thrombocytosis, thrombophilia, and associated chronic liver disease. Nevertheless, combined treatment with intravenous heparin and thrombolysis and the myeloproliferative inhibitor hydroxyurea was associated with a favorable outcome. CONCLUSION: The risk of pulmonary thromboembolic complications and their management after splenectomies for hematologic disease warrant further study.
Authors:
Anna Agnese Stanziola; Sergio Padula; Emanuela Carpentieri; Gaetano Rea; Mauro Maniscalco; Matteo Sofia
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-18
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  -     ISSN:  1527-3288     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Respiratory Medicine, Monaldi Hospital, University Federico II of Naples, Naples, Italy.
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