Analysis of portal vein thrombosis after splenectomy

Objective To investigate the etiopathogenesis of portal vein thrombosis (PVT) after splenectomy as well as the strategy for it's diagnosis and treatment.Methods Clinical data of 15 patients with PVT after splenectomy from June 2004 to July 2008 were retrospectively analyzed.Results Among the 247 patients subject to splenectomy,15 cases suffered from PVT (6.1%).The average time from onset of symptoms to diagnosis of PVT was 6.1±3.5 days. All patients exhibited leukocytosis and elevated platelet counts.The diagnosis of PVT was established by Doppler ultra- sound or by contrast - enhanced CT scanning in all cases.In these patients,except 1 case of death for septic shock after intestinal necrosis,all patients recovered.Conclusions Thrombocytosis after splenectomy as well as the changes of portal hemodynamics is the main reason for portal vein thrombosis.Monitoring of platelet number,examination of routine color ultrasonography and early anticoagulation therapy are the effective methods in preventing and managing portal thrombosis postoperatively for cases with splenectomy.