Splenic vein thrombosis surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Splenic vein thrombosis}} | {{Splenic vein thrombosis}} | ||
{{CMG}} ; {{AE}} {{Vbe}} | {{CMG}} ; {{AE}} {{Vbe}}{{SKA}} | ||
==Overview== | ==Overview== | ||
[[Splenectomy|Splenectom]]<nowiki/>y is recommended for all [[patients]] with bleeding varices associated with isolated | [[Splenectomy|Splenectom]]<nowiki/>y is recommended for all [[patients]] with bleeding varices associated with isolated splenic vein thrombosis. [[Splenectomy]] eliminates venous collateral outflow and decompresses surrounding [[varices]]. | ||
==Surgery== | ==Surgery== | ||
[[Splenectomy]] is recommended for all patients with [[bleeding]] varices associated with isolated | [[Splenectomy]] is recommended for all patients with [[bleeding]] varices associated with isolated splenic vein thrombosis. Splenectomy eliminates venous collateral outflow and decompresses surrounding varices. | ||
Splenic arterial embolization: | 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'''portal vein thrombosis 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'''| 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}} | ||
Latest revision as of 16:25, 1 March 2018
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Splenic vein thrombosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Splenic vein thrombosis surgery On the Web |
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American Roentgen Ray Society Images of Splenic vein thrombosis surgery |
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Risk calculators and risk factors for Splenic vein thrombosis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]Sunny Kumar MD [3]
Overview
Splenectomy is recommended for all patients with bleeding varices associated with isolated splenic vein thrombosis. Splenectomy eliminates venous collateral outflow and decompresses surrounding varices.
Surgery
Splenectomy is recommended for all patients with bleeding varices associated with isolated splenic vein thrombosis. Splenectomy eliminates venous collateral outflow and decompresses surrounding varices.
Splenic arterial embolization:[1][2][3][4][5]
- Rarely studied, associated with splenic abscess, and is recommended for patients with high operative risk and patients with diffuse metastatic disease.
| Abdominal pain and systemic inflammation and/or Thrombophilic factor | |||||||||||||||||||
| Confirm PVTportal vein thrombosis 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 | No | ||||||||||||||||||
| Discuss urgent laparotomy with senior surgeon | Close monitoring *Anti-coagulation continued for 6 months | ||||||||||||||||||
References
- ↑ 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.
- ↑ Valla D (2015). "Splanchnic Vein Thrombosis". Semin Thromb Hemost. 41 (5): 494–502. doi:10.1055/s-0035-1550439. PMID 26080307.
- ↑ 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.
- ↑ 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.
- ↑ 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.