Splenic vein thrombosis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

Though thrombosis of the splenic vein is infrequently reported in the literature,1 , 2 it is common knowledge among surgeons that this condition may follow splenectomy. In fact, local thrombosis at the site of ligation of the splenic artery and vein with extension back to the first branching vessel is to be expected. This degree of involvement of the splenic vein, however, should be symptom less, but it is potentially important because of possible extension into the portal venous system and as a source of emboli to the liver.

Historical Perspective and Land marks

Though thrombosis of the splenic vein is infrequently reported in the literature, the literature though infrequently studied, articles were published in the New England journal of medicine in the late 1940's. Benjamin etal described cases of splenic vein thrombosis following trans thoracic gastrectomy and incidental splenectomy. In the year 1952, Percutaneous splenoportography was first described by Dreyer and Bandtz which helped to increase the discovery rate of causes of splenic vein thrombosis.

In the year 1956, three cases of splenic vein thrombosis were diagnosed by percutaneous splenoportography among 36 splenectomies done at Ohio State University hospitals for hematologic cases.

In the year 1951 a German article cited cases of portal embolism following thrombosis of splenic vein and causing infarct like cyanotic atrophy('Zahn's infarcts') of the liver, as a complication of splenectomy in the course of total gatsrectomy.

In 2016- Atypical case of splenic vein thrombosis has been reported in patients with epiastric pain whose initial diagnosis was presumed to be gastritis but later were diagnosed as having biopsy proven pancreatic cancer [1]

Spleno portal thrombosis accompanying complications of Banti's disease has been reported in 1960's

In 1970's Cases of splenic vein thrombosis secondary to pancreatic disease have been reported

In 1990's - Weber Christian disease producing splenic vein occlusion and bleeding gastric varices and it's successful treatment with sclerotherapy was described in British Medical Journal [2]

In early 2000's Splenic vein thrombosis has been reported in pediatric sickle cell disease and splenic vein thrombosis secondary to mutation of prothrombin gene has been reported. [3]

In late 2000's Cases of splenic vein thrombosis associated with antiphospholipid antibodies in a patient with wegener's granulomatosis has been reported. [4]

References

  1. McIntyre B, Marsh M, Walden J (2016). "Puzzles in practice: splenic vein thrombosis". Postgrad Med. 128 (5): 538–40. doi:10.1080/00325481.2016.1185922. PMID 27157637.
  2. Heseltine D, Bramble M, Cole A, Clarke D, Castle W (1990). "Weber-Christian disease producing splenic vein occlusion and bleeding gastric varices: successful treatment with sclerotherapy". Postgrad Med J. 66 (774): 321–5. PMC 2429406. PMID 2385562.
  3. Frutos Bernal MD, Fernández Hernández JA, Carrasco Prats M, Soria Cogollos T, Luján Mompeán JA, Hernández Agüera Q, Parrilla Paricio P (2005). "[Portal-splenic-mesenteric venous thrombosis secondary to a mutation of the prothrombin gene]". Gastroenterol Hepatol (in Spanish; Castilian). 28 (6): 329–32. PMID 15989814.
  4. Steen KS, Peters MJ, Zweegman S, de Groot PG, Voskuyl AE (2007). "Relapsing splenic vein thrombosis associated with antiphospholipid antibodies in a patient with wegener granulomatosis". J Clin Rheumatol. 13 (2): 92–3. doi:10.1097/01.rhu.0000260410.81377.b2. PMID 17414539.