Significance of splenic vein thrombosis in chronic pancreatitis.
BACKGROUND
Splenic vein thrombosis leading to sinistral portal hypertension and variceal bleeding is a complication of chronic pancreatitis. The management of these patients without variceal bleeding remains controversial.


METHODS
A total of 157 patients with chronic pancreatitis were managed consecutively in our center between January 1996 and December 2005. Thirty-four patients with chronic pancreatitis were diagnosed to have splenic vein thrombosis.


RESULTS
The incidence of splenic vein thrombosis in patients with chronic pancreatitis was 22%. Fifteen percent of patients with chronic pancreatitis and splenic vein thrombosis presented with gastroesophageal variceal bleeding. Nine patients underwent splenectomy along with pancreatic procedures and 21 patients underwent pancreatic procedures only. Adding splenectomy to the pancreatic procedure did not lead to increased morbidity or mortality.


CONCLUSIONS
Splenectomy should be added to the pancreatic procedure in patients who have evidence of portal hypertension on preoperative evaluation, especially if gastric varices are found.
Agarwal
Anil K
AK
Department of Gastrointestinal Surgery, Gobind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi 110002, India. aka.gis@gmail.com
Raj Kumar
K
K
Agarwal
Shaleen
S
Singh
Shivendra
S
D000328:Adult; D003952:Diagnostic Imaging; D004322:Drainage; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D015994:Incidence; D008297:Male; D010180:Pancreatectomy; D010193:Pancreaticojejunostomy; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000601:surgery; D013156:Splenectomy; D013162:Splenic Vein; D020246:Venous Thrombosis / Q000150:complications* / Q000601:surgery