Portal, mesenteric, and splenic vein thromboses after splenectomy in a patient with chronic myeloid leukemia variant with thrombocythemic onset.
Portal, mesenteric, or splenic vein thrombosis is a very uncommon complication with significant mortality in the patients undergoing splenectomy for hematologic disorders. We report a 49-year-old woman who developed portal, superior mesenteric, and splenic vein thromboses after splenectomy. Four years before the event, she presented with a marked thrombocytosis and was diagnosed to have chronic myeloid leukemia variant with thrombocythemic onset as evidence by Philadelphia (Ph1) chromosome and a b3a2 BCR/ABL transcript. Six weeks after splenectomy, she developed severe epigastric pain. The diagnosis of thromboses of portal, mesenteric, and splenic veins was made by computed tomography scan and Doppler sonogram. She was successfully treated with antegrade intraarterial urokinase therapy via superior mesenteric artery and long-term anticoagulant therapies. To our knowledge, our patient is the first case of portal, mesenteric, and splenic vein thromboses after splenectomy in a patient with CML variant with thrombocythemic onset successfully treated with antegrade intraarterial thrombolytic therapy followed by anticoagulant therapies.
Department of Internal Medicine, Chonnam National University Medical School, Kwangju, South Korea. ljj1225@netian.com
J J
JJ
Lee
H J
HJ
Kim
I J
IJ
Chung
M R
MR
Park
K S
KS
Seo
Y Y
YY
Jeong
J K
JK
Kim
D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery*; D008642:Mesenteric Veins; D008875:Middle Aged; D011169:Portal Vein; D011183:Postoperative Complications; D013154:Spleen / Q000098:blood supply*; D013156:Splenectomy / Q000009:adverse effects*; D013922:Thrombocytosis / Q000209:etiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*