title: [Routine screening of splenic or portal vein thrombosis after splenectomy].
abstract: BACKGROUND
  Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy.
  
  
  METHODS
  Since January 2012, all patients undergoing an elective splenectomy had an abdominal CT-scan on postoperative-day 7. Demographic data, pathology, type of surgery, platelet counts before and after surgery, outcome, results of medical imaging, and management of PSVT and its results were recorded.
  
  
  RESULTS
  Over 3 years, 52 patients underwent an elective splenectomy. All of them had a CT-scan at postoperative-day 7. A PSVT was found in 11 patients (21.2 %). They were all asymptomatic. Lymphoma and splenomegaly were the main factors associated with PSVT in the univariate analysis. All patients with PSVT were treated with anticoagulation and no complication of PSVT occurred. The follow-up CT confirmed the efficacy of anticoagulation therapy in all patients.
  
  
  CONCLUSIONS
  Routine screening of PSVT after elective splenectomy is warranted because it allows to start anticoagulant therapy and avoid further life-threatening complications. The incidence of PSVT is particularly high among patients operated on for lymphoma or with splenomegaly.
authors.affiliation: Service de chirurgie digestive et cancérologique, CHU Bocage Central, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France. Electronic address: aurelie.ravoire@chu-dijon.fr.
authors.forename: A
authors.initials: A
authors.lastname: Bouvier
authors.affiliation: Service de chirurgie digestive et cancérologique, CHU Bocage Central, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Gout
authors.affiliation: Service de médecine interne, CHU Le Bocage, Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Audia
authors.affiliation: Service de chirurgie digestive, centre hospitalier Chalon-sur-Saône, Chalon-sur-Saône, France.
authors.forename: C
authors.initials: C
authors.lastname: Chalumeau
authors.affiliation: Service de chirurgie digestive et cancérologique, CHU Bocage Central, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Rat
authors.affiliation: Service de chirurgie digestive et cancérologique, CHU Bocage Central, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.
authors.forename: O
authors.initials: O
authors.lastname: Deballon
mesh_terms: D000328:Adult; D000368:Aged; D003955:Diagnostic Tests, Routine; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D013158:Splenic Diseases / Q000175:diagnosis* / Q000209:etiology; D013162:Splenic Vein / Q000473:pathology*; D013163:Splenomegaly / Q000601:surgery; D020246:Venous Thrombosis
keywords: Dépistage; Portal vein thrombosis; Screening; Splenectomy; Splenic vein thrombosis; Splénectomie; Thrombose portale; Thrombose veineuse splénique