Splenic vein thrombosis surgery: Difference between revisions

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Splenic arterial embolization:.<ref name="pmid276399112">{{cite journal |vauthors=Bouvier A, Gout M, Audia S, Chalumeau C, Rat P, Deballon O |title=[Routine screening of splenic or portal vein thrombosis after splenectomy] |language=French |journal=Rev Med Interne |volume=38 |issue=1 |pages=3–7 |year=2017 |pmid=27639911 |doi=10.1016/j.revmed.2016.08.003 |url=}}</ref><ref name="pmid260803072">{{cite journal| author=Valla D| title=Splanchnic Vein Thrombosis. | journal=Semin Thromb Hemost | year= 2015 | volume= 41 | issue= 5 | pages= 494-502 | pmid=26080307 | doi=10.1055/s-0035-1550439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26080307  }}</ref><ref name="pmid292113742">{{cite journal| author=Gouin B, Robert-Ebadi H, Casini A, Beauverd Y, Fontana P, Righini M et al.| title=[Splanchnic vein thrombosis]. | journal=Rev Med Suisse | year= 2017 | volume= 13 | issue= 586 | pages= 2138-2143 | pmid=29211374 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211374  }}</ref><ref name="pmid29202678">{{cite journal| author=Riva N, Ageno W| title=Approach to thrombosis at unusual sites: Splanchnic and cerebral vein thrombosis. | journal=Vasc Med | year= 2017 | volume= 22 | issue= 6 | pages= 529-540 | pmid=29202678 | doi=10.1177/1358863X17734057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29202678  }}</ref><ref name="pmid23026649">{{cite journal| author=Riva N, Donadini MP, Dentali F, Squizzato A, Ageno W| title=Clinical approach to splanchnic vein thrombosis: risk factors and treatment. | journal=Thromb Res | year= 2012 | volume= 130 Suppl 1 | issue=  | pages= S1-3 | pmid=23026649 | doi=10.1016/j.thromres.2012.08.259 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23026649  }}</ref>
Splenic arterial embolization:.<ref name="pmid276399112">{{cite journal |vauthors=Bouvier A, Gout M, Audia S, Chalumeau C, Rat P, Deballon O |title=[Routine screening of splenic or portal vein thrombosis after splenectomy] |language=French |journal=Rev Med Interne |volume=38 |issue=1 |pages=3–7 |year=2017 |pmid=27639911 |doi=10.1016/j.revmed.2016.08.003 |url=}}</ref><ref name="pmid260803072">{{cite journal| author=Valla D| title=Splanchnic Vein Thrombosis. | journal=Semin Thromb Hemost | year= 2015 | volume= 41 | issue= 5 | pages= 494-502 | pmid=26080307 | doi=10.1055/s-0035-1550439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26080307  }}</ref><ref name="pmid292113742">{{cite journal| author=Gouin B, Robert-Ebadi H, Casini A, Beauverd Y, Fontana P, Righini M et al.| title=[Splanchnic vein thrombosis]. | journal=Rev Med Suisse | year= 2017 | volume= 13 | issue= 586 | pages= 2138-2143 | pmid=29211374 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211374  }}</ref><ref name="pmid29202678">{{cite journal| author=Riva N, Ageno W| title=Approach to thrombosis at unusual sites: Splanchnic and cerebral vein thrombosis. | journal=Vasc Med | year= 2017 | volume= 22 | issue= 6 | pages= 529-540 | pmid=29202678 | doi=10.1177/1358863X17734057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29202678  }}</ref><ref name="pmid23026649">{{cite journal| author=Riva N, Donadini MP, Dentali F, Squizzato A, Ageno W| title=Clinical approach to splanchnic vein thrombosis: risk factors and treatment. | journal=Thromb Res | year= 2012 | volume= 130 Suppl 1 | issue=  | pages= S1-3 | pmid=23026649 | doi=10.1016/j.thromres.2012.08.259 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23026649  }}</ref>
* Rarely studied, associated with [[splenic abscess]], and is recommended for patients with high operative risk and patients with diffuse [[metastatic disease]].
* Rarely studied, associated with [[splenic abscess]], and is recommended for patients with high operative risk and patients with diffuse [[metastatic disease]].
{{Family tree/start}}
{{Family tree | | | | A01 | | | |A01=Abdominal pain and systemic inflammation<br>and/or<br>thrombophilic factor }}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | B01 | | | |B01=Confirm PVT with unenhanced or contrast CT after informing radiologist about suspicion of PVT}}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | C01 | | | |C01= screen for general and local cause}}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | F01 | | | |F01= Start LMWH<br> start antibiotic if septic thrombophlebitis<br>treat accurate cause when identified}}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | D01 | | | |D01= '''If'''<br>*Presenting sever abdominal pain despite of adequate anti-coagulation<br>*Organ failure<br>*Rectal bleeding }}
{{Family tree | |,|-|-|^|-|-|.| | }}
{{Family tree | E01 | | | | E02 |E01='''Yes''' 3| E02='''No'''}}
{{Family tree | |!| | | | | |!| | }}
{{Family tree | G01 | | | | G02 |G01=Discuss urgent laparotomy with senior surgeon|G02= Close monitoring<br>*Anti-coagulation continued for 6 months }}
{{Family tree/end}}
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 16:36, 5 February 2018

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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

Splenectomy is recommended for all patients with bleeding varices associated with isolated splenic vein thrombosis. Splenectomy eliminates venous collateral out flow, decompresses surrounding varices.

Surgery

Splenectomy is recommended for all patients with bleeding varices associated with isolated splenic vein thrombosis. splenectomy eliminates venous collateral out flow, decompresses surrounding varices.

Splenic arterial embolization:.[1][2][3][4][5]

 
 
 
Abdominal pain and systemic inflammation
and/or
thrombophilic factor
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Confirm PVT with unenhanced or contrast CT after informing radiologist about suspicion of PVT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
screen for general and local cause
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Start LMWH
start antibiotic if septic thrombophlebitis
treat accurate cause when identified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If
*Presenting sever abdominal pain despite of adequate anti-coagulation
*Organ failure
*Rectal bleeding
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes 3
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
Discuss urgent laparotomy with senior surgeon
 
 
 
Close monitoring
*Anti-coagulation continued for 6 months

References

  1. Bouvier A, Gout M, Audia S, Chalumeau C, Rat P, Deballon O (2017). "[Routine screening of splenic or portal vein thrombosis after splenectomy]". Rev Med Interne (in French). 38 (1): 3–7. doi:10.1016/j.revmed.2016.08.003. PMID 27639911.
  2. Valla D (2015). "Splanchnic Vein Thrombosis". Semin Thromb Hemost. 41 (5): 494–502. doi:10.1055/s-0035-1550439. PMID 26080307.
  3. Gouin B, Robert-Ebadi H, Casini A, Beauverd Y, Fontana P, Righini M; et al. (2017). "[Splanchnic vein thrombosis]". Rev Med Suisse. 13 (586): 2138–2143. PMID 29211374.
  4. Riva N, Ageno W (2017). "Approach to thrombosis at unusual sites: Splanchnic and cerebral vein thrombosis". Vasc Med. 22 (6): 529–540. doi:10.1177/1358863X17734057. PMID 29202678.
  5. Riva N, Donadini MP, Dentali F, Squizzato A, Ageno W (2012). "Clinical approach to splanchnic vein thrombosis: risk factors and treatment". Thromb Res. 130 Suppl 1: S1–3. doi:10.1016/j.thromres.2012.08.259. PMID 23026649.