Splenic vein thrombosis (patient information)
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Splenic vein thrombosis |
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Splenic vein thrombosis On the Web |
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Risk calculators and risk factors for Splenic vein thrombosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Splenic vein thrombosis is a blood clot that is obstructing the splenic vein, which is located on the surface of the spleen. The increased pressure in the splenic vein causes the spleen to enlarge, and other veins to dilate and twist in the esophagus and stomach; internal bleeding may occur.
What are the Symptoms of (Splenic vein thrombosis)?
About half of people with DVT have no signs or symptoms at all. The following are the most common signs and symptoms of DVT that occur in the affected part of the body:
Swelling
Pain
Tenderness
Redness of the skin
If you have any of these symptoms, you should see your doctor as soon as possible.
What Causes (Splenic vein thrombosis)?
Acute PVT, which is the sudden formation of a thrombus, can present with severe abdominal pain, ascites, diarrhea, ileus, fever or nausea. Chronic PVT, which develops in patients with acute PVT that was not resolved, can also present asymptomatically or with an entirely new set of symptoms, including pain, ascites, hematemesis, varices or melena.
A vein's inner lining is damaged. Injuries caused by physical, chemical, or biological factors can damage the veins. Such factors include surgery, serious injuries, inflammation, and immune responses.
Blood flow is sluggish or slow. Lack of motion can cause sluggish or slow blood flow. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
Your blood is thicker or more likely to clot than normal. Some inherited conditions (such as factor V Leiden) increase the risk of blood clotting. Hormone therapy or birth control pills also can increase the risk of clotting.
Who is at Highest Risk?
Deep vein thrombosis ais serious but preventable medical conditions caused by blood clots that form in a vein. It is important to know about DVT because it can happen to anyone at any age and can cause serious illness, disability, and in some cases, death. The good news is that these types of blood clots are preventable and treatable if discovered early.
The risk factors for deep vein thrombosis (DVT) include:
- A history of DVT.
- Conditions or factors that make your blood thicker or more likely to clot than normal. Some inherited blood disorders (such as factor V Leiden) will do this. Hormone therapy or birth control pills also increase the risk of clotting.
- Injury to a deep vein from surgery, a broken bone, or other trauma.
- Slow blood flow in a deep vein due to lack of movement. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
- Pregnancy and the first 6 weeks after giving birth.
- Recent or ongoing treatment for cancer.
- A central venous catheter. This is a tube placed in a vein to allow easy access to the bloodstream for medical treatment.
- Older age. Being older than 60 is a risk factor for DVT, although DVT can occur at any age.
- Overweight or obesity.
- Smoking.
Your risk for DVT increases if you have more than one of the risk factors listed above.
Diagnosis
- D-dimer Test (American Association for Clinical Chemistry)
- Doppler Ultrasound: What Is It Used for? (Mayo Foundation for Medical Education and Research)
- How Is Deep Vein Thrombosis Diagnosed? (National Heart, Lung, and Blood Institute)
- Venography (American College of Radiology, Radiological Society of North America)Also in Spanish
- Venous Ultrasound (Extremities) (American College of Radiology, Radiological Society of North America)Also in Spanish
Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms.
For some people, DVT might not be diagnosed until after they receive emergency treatment for pulmonary embolism (PE).
Medical History
To learn about your medical history, your doctor may ask about:
- Your overall health
- Any prescription medicines you're taking
- Any recent surgeries or injuries you've had
- Whether you've been treated for cancer
Physical Exam
Your doctor will check your legs for signs of DVT, such as swelling or redness. He or she also will check your blood pressure and your heart and lungs.
Diagnostic Tests
Your doctor may recommend tests to find out whether you have DVT.
Common Tests
The most common test for diagnosing deep vein blood clots is ultrasound. This test uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg.
Your doctor also may recommend a D-dimer test or venography (ve-NOG-rah-fee).
A D-dimer test measures a substance in the blood that's released when a blood clot dissolves. If the test shows high levels of the substance, you may have a deep vein blood clot. If your test results are normal and you have few risk factors, DVT isn't likely.
Your doctor may suggest venography if an ultrasound doesn't provide a clear diagnosis. For venography, dye is injected into a vein in the affected leg. The dye makes the vein visible on an x-ray image. The x ray will show whether blood flow is slow in the vein, which may suggest a blood clot.
When to Seek Urgent Medical Care?
You can take steps to prevent deep vein thrombosis (DVT) . If you're at risk for these conditions:
- See your doctor for regular checkups.
- Take all medicines as your doctor prescribes.
- Get out of bed and move around as soon as possible after surgery or illness (as your doctor recommends). Moving around lowers your chance of developing a blood clot.
- Exercise your lower leg muscles during long trips. This helps prevent blood clots from forming.
If you've had DVT before, you can help prevent future blood clots. Follow the steps above and:
- Take all medicines that your doctor prescribes to prevent or treat blood clots
- Follow up with your doctor for tests and treatment
- Use compression stockings as your doctor directs to prevent leg swelling
Contact your doctor at once if you have any signs or symptoms of DVT
Treatment Options
Doctors treat deep vein thrombosis (DVT) with medicines and other devices and therapies. The main goals of treating DVT are to:
- Stop the blood clot from getting bigger
- Prevent the blood clot from breaking off and moving to your lungs
- Reduce your chance of having another blood clot
Medicines
Your doctor may prescribe medicines to prevent or treat DVT.
Anticoagulants
Anticoagulants (AN-te-ko-AG-u-lants) are the most common medicines for treating DVT. They're also known as blood thinners.
These medicines decrease your blood's ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can't break up blood clots that have already formed. (The body dissolves most blood clots with time.)
Blood thinners can be taken as a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).
Warfarin and heparin are two blood thinners used to treat DVT. Warfarin is given in pill form. (Coumadin® is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.
Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.
Pregnant women usually are treated with just heparin because warfarin is dangerous during pregnancy.
Treatment for DVT using blood thinners usually lasts for 6 months. The following situations may change the length of treatment:
- If your blood clot occurred after a short-term risk (for example, surgery), your treatment time may be shorter.
- If you've had blood clots before, your treatment time may be longer.
- If you have certain other illnesses, such as cancer, you may need to take blood thinners for as long as you have the illness.
The most common side effect of blood thinners is bleeding. Bleeding can happen if the medicine thins your blood too much. This side effect can be life threatening.
Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually have regular blood tests to measure their blood's ability to clot. These tests are called PT and PTT tests.
These tests also help your doctor make sure you're taking the right amount of medicine. Call your doctor right away if you have easy bruising or bleeding. These may be signs that your medicines have thinned your blood too much.
Thrombin Inhibitors
These medicines interfere with the blood clotting process. They're used to treat blood clots in patients who can't take heparin.
Thrombolytics
Doctors prescribe these medicines to quickly dissolve large blood clots that cause severe symptoms. Because thrombolytics can cause sudden bleeding, they're used only in life-threatening situations.
Other Types of Treatment
Vena Cava Filter
If you can't take blood thinners or they're not working well, your doctor may recommend a vena cava filter.
The filter is inserted inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. However, the filter doesn't stop new blood clots from forming.
Graduated Compression Stockings
Graduated compression stockings can reduce leg swelling caused by a blood clot. These stockings are worn on the legs from the arch of the foot to just above or below the knee.
Compression stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.
There are three types of compression stockings. One type is support pantyhose, which offer the least amount of pressure.
The second type is over-the-counter compression hose. These stockings give a little more pressure than support pantyhose. Over-the-counter compression hose are sold in medical supply stores and pharmacies.
Prescription-strength compression hose offer the greatest amount of pressure. They also are sold in medical supply stores and pharmacies. However, a specially trained person needs to fit you for these stockings.
Talk with your doctor about how long you should wear compression stockings.
Prevention Travel Tips
The risk of developing DVT while traveling is low. The risk increases if the travel time is longer than 4 hours or you have other DVT risk factors.
During long trips, it may help to:
- Walk up and down the aisles of the bus, train, or airplane. If traveling by car, stop about every hour and walk around.
- Move your legs and flex and stretch your feet to improve blood flow in your calves.
- Wear loose and comfortable clothing.
- Drink plenty of fluids and avoid alcohol.
If you have risk factors for DVT, your doctor may advise you to wear compression stockings while traveling. Or, he or she may suggest that you take a blood-thinning medicine before traveling.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm
https://medlineplus.gov/ency/article/001157.htm