Splenic vein thrombosis differential diagnosis

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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

Splenic vein thrombosis (SVT) must be differentiated from hepatic vein thrombosis (HVT), portal vein thrombosis (PVT), testicular cancer, hyperhomocystenemia, and deep vein thrombosis.^[1]^[2]^[3]

Disease	Abdominal pain	Leg swelling	Portal HTN	Rectal bleeding	CT abdomen	Doppler US of deep viens	Urine chemistry
SVT	Present	Absent	Present	Present	Thrombosis in SV	Normal	Normal
HVT	Present	Absent	Present	Present	Thrombosis in HV	Normal	Normal
Hyperhomocystenemia	Present	Absent	Present if PVT	Present if PVT	No specific finding	May have thrombosis if deep veins involved	Elevated homocysteine
DVT	Present	Present	Absent	Absent	No specific	Thrombosis in deep veins	Normal
PVT	Present	Absent	Present	Present	Thrombosis in PV	Normal	Normal

↑ Venkatesh P, Shaikh N, Malmstrom MF, Kumar VR, Nour B (2014). "Portal, superior mesenteric and splenic vein thrombosis secondary to hyperhomocysteinemia with pernicious anemia: a case report". J Med Case Rep. 8: 286. doi:10.1186/1752-1947-8-286. PMC 4154050. PMID 25155131.
↑ Salazar-Mejía CE, Hernández-Barajas D, Llerena-Hernández E, González-Vela JL, Contreras-Salcido MI, González-Gutiérrez A, Borjas-Almaguer OD, Pérez-Arredondo LA, Wimer-Castillo BO (2017). "Testicular Cancer Presenting as Gastric Variceal Hemorrhage". Case Rep Gastrointest Med. 2017: 4510387. doi:10.1155/2017/4510387. PMC 5695022. PMID 29234547.
↑ Bertrand A, Heissat S, Caron N, Viremouneix L, Pracros JP, Javouhey E, Lachaux A, Mialou V (2014). "[Deep vein thrombosis revealing myeloproliferative syndrome in two adolescents]". Arch Pediatr (in French). 21 (5): 497–500. doi:10.1016/j.arcped.2014.02.019. PMID 24709317.