Splenic and portal vein thrombosis following laparoscopic splenectomy in a pediatric patient with chronic myeloid leukemia.
BACKGROUND
Splenic or portal vein thrombosis is a rare complication following splenectomy.


METHODS
We report a case of splenic and portal venous thrombosis in a 10-year-old girl with chronic myeloid leukemia who underwent laparoscopic splenectomy prior to bone marrow transplant. Clinical suspicion of such thrombosis should be high for patients who have had splenectomy. The diagnosis is confirmed by Doppler ultrasound or contrast-enhanced computed tomography; magnetic resonance imaging magnetic resonance angiography or arteriography can also be used. Proposals for postoperative screening protocols are discussed. Patients with primary myeloproliferative disorders are at increased risk of portal vein thrombosis, independent of surgical intervention, perhaps due to platelet dysfunction resulting from abnormalities of pluripotent stem cells. Marked splenomegaly (with larger draining veins) is thought to increase the risk of thrombosis.
Lederman
Henrique Manoel
HM
The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, USA. lederman.ddi@epm.br
Fieldston
Evan
E
D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery*; D010976:Platelet Count; D011169:Portal Vein; D011184:Postoperative Period; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods; D013162:Splenic Vein; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*