Portal thrombosis. A rare complication of laparoscopic splenectomy

Surg Endosc. 1998 Sep;12(9):1173-6. doi: 10.1007/s004649900810.

Abstract

Portal thrombosis is a rare complication of splenectomy. We performed 12 laparoscopic splenectomies and observed this complication only in one patient with idiopathic thrombocytopenia (ITP). The right branch of the portal vein presented a partial thrombosis, while the left branch was completely obstructed by thrombi. Abdominal ultrasonography and an ultrasound doppler exam allowed us to diagnose this event and a retrograde angiography performed afterward confirmed our diagnosis. A 48-h intravenous heparin treatment was promptly begun, followed by anticoagulant drugs (dicumarol). The patient was dismissed 5 days afterward, presenting a steady-state ultrasound doppler pattern and a complete normalization of liver parameters. An ultrasound doppler exam performed 1 month after anticoagulant therapy showed a complete resolution of portal thrombosis. We believe that early diagnosis of this rare complication, prompt beginning of anticoagulant therapy, and care in surgical procedures may reduce patient life-threatening risks and assure complete remission.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Laparoscopy / adverse effects*
  • Portal Vein*
  • Splenectomy / adverse effects*
  • Splenectomy / methods
  • Thrombosis / diagnosis
  • Thrombosis / drug therapy
  • Thrombosis / etiology*