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Radiology, Vol 190, 65-68, Copyright © 1994 by Radiological Society of North America

ARTICLES

Splenic vein thrombosis after splenectomy: frequency and role of imaging

P Petit, PM Bret, M Atri, A Hreno, G Casola and D Gianfelice
Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.

PURPOSE: To assess the frequency of splenic vein thrombosis (SVT) after splenectomy and its consequences on patient treatment. MATERIALS AND METHODS: A group of 183 consecutive patients who underwent splenectomy were evaluated. Of these patients, 119 underwent postoperative ultrasound (US) or computed tomography. RESULTS: SVT was diagnosed in 13 of 119 patients in the first 2 weeks after surgery. In these 13 patients, splenectomy had been performed for hematologic disorders (n = 12) or trauma (n = 1). Seven of the 13 patients were asymptomatic. After anticoagulant therapy, follow-up US of 12 patients showed resolution of thrombosis with no complications in 10 patients; two patients developed cavernous transformation of the portal vein. CONCLUSION: Since only 65% of patients underwent imaging, the true frequency of SVT could not be determined; however, it occurred in at least 7% of patients who underwent splenectomy. Routine Doppler US should be performed after splenectomy to allow early anticoagulant therapy in patients with SVT.


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