SPLENIC VEIN-THROMBOSIS AFTER SPLENECTOMY - FREQUENCY AND ROLE OF IMAGING

PURPOSE: To assess the frequency of splenic vein thrombosis (SVT) afte r splenectomy and its consequences on patient treatment. MATERIALS AND METHODS: A group of 183 consecutive patients who underwent splenectom y were evaluated. Of these patients, 119 underwent postoperative ultra sound (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 ant icoagulant therapy, follow-up US of 12 patients showed resolution of t hrombosis with no complications in 10 patients; two patients developed cavernous transformation of the portal vein. CONCLUSION: Since only 6 5% of patients underwent imaging, the true frequency of SVT could not be determined; however, it occurred in at least 7% of patients who und erwent splenectomy. Routine Doppler US should be performed after splen ectomy to allow early anticoagulant therapy in patients with SVT.