Portal thrombosis. A rare complication of laparoscopic splenectomy.
Portal thrombosis is a rare complication of splenectomy. We performed 12 laparoscopic splenectomies and observed this complication only in one patient with idiopathic thrombocytopenia (ITP). The right branch of the portal vein presented a partial thrombosis, while the left branch was completely obstructed by thrombi. Abdominal ultrasonography and an ultrasound doppler exam allowed us to diagnose this event and a retrograde angiography performed afterward confirmed our diagnosis. A 48-h intravenous heparin treatment was promptly begun, followed by anticoagulant drugs (dicumarol). The patient was dismissed 5 days afterward, presenting a steady-state ultrasound doppler pattern and a complete normalization of liver parameters. An ultrasound doppler exam performed 1 month after anticoagulant therapy showed a complete resolution of portal thrombosis. We believe that early diagnosis of this rare complication, prompt beginning of anticoagulant therapy, and care in surgical procedures may reduce patient life-threatening risks and assure complete remission.
U.O. Chirurgia Generale e Vascolare, Azienda Ospedlaiera Careggi, Firenze, Italy.
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Valeri
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Venneri
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Presenti
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Nardi
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Grossi
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D
Borrelli
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D011169:Portal Vein; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*