Acute Massive Splenic Infarction with Splenic Vein Thrombosis Following Altitude Exposure of a Sri Lankan Male with Undetected Sickle Cell Trait

2012 ◽  
Vol 13 (4) ◽  
pp. 288-290 ◽  
Author(s):  
Walimuni Yohan Mendis Abeysekera ◽  
Warusha Dhammika Dulantha de Silva ◽  
Sharika Shashindrani Pinnaduwa ◽  
Anura Sarath Kumara Banagala
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Splenic Vein ◽  
Splenic Infarction ◽  
Sri Lankan ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Altitude Exposure

Etiology and Management of Splenic Infarction and Splenic Vein Thrombosis: Unusual Causes of Abdominal Pain in Sickle Cell Trait Patient

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4775-4775 ◽  
Author(s):  
Vladimir Gotlieb ◽  
Shuang Fu ◽  
Prajwol Pathak ◽  
Jeeny Job ◽  
Steve Walerstein ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Splenic Vein ◽  
Splenic Infarction ◽  
Cell Disease ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Splenic Infarct

Abstract Abstract 4775 Abdominal pain is a common complaint among all ages of patients. Splenic infarction and splenic vein thrombosis are rare causes of abdominal pain, usually presenting as left-sided abdominal pain associated with fever, nausea or vomiting, and elevated white blood cell count. CT scan is currently the preferred diagnostic test. Once the diagnosis is identified, the etiology of splenic infarction and/or splenic vein thrombosis should be elicited. Retrospective chart review was conducted in all the patients admitted to our hospital from 2000 till now. Four cases of splenic infarction and/or splenic vein thrombosis were identified (4 males, average age of 45 years, range from 38 to 52 years). Case 1, a 45-year-old male with sickle cell trait (HbS of 38.7%), presented with left upper quadrant pain after 5-hour flight and alcohol binge prior to flight. CT showed splenic infarct and splenic vein thrombosis. Patient received aggressive hydration, abdominal pain resolved and was discharged home. Case 2, a 52-year-old male with renal cell carcinoma, presented with generalized abdominal pain. CT showed splenic infarct. Patient was treated with Coumadin, and routinely followed-up at Oncology clinic. Case 3, a 38-year old male with alcohol abuse and chronic pancreatitis, presented with recurrent abdominal pain and hypersplenism. CT showed splenic vein thrombosis, and the patient underwent splenectomy. Case 4, a 45-year-old male with acute pancreatitis, presented with epigastric pain. CT showed splenic vein thrombosis, and the patient was treated with Coumadin. It is important to reveal the underlying causes for splenic infarction and/or splenic vein thrombosis. Splenic infarction can occur in a variety of settings, including hemoglobinopathy (especially sickle cell disease), hypercoagulable state, embolic disease, malignancy and myeloproliferative disorders. Pancreatitis and pancreatic cancer are the most common causes of splenic vein thrombosis. In general, splenic infarction and/or splenic vein thrombosis can be managed safely with medical treatment, including hydration, oxygenation and pain management. Coumadin can be considered in cancer patients with splenic infarction and in patients with splenic vein thrombosis. Splenectomy is indicated in patients with hypersplenism, splenic sequestration crisis, splenic abscess, splenic rupture, and massive splenic infarction. Splenic infarction in sickle cell disease is usually small and repetitive, leading ultimately to autosplenectomy. Splenic infarction in sickle cell trait is rare. High altitude, vigorous exercise, airplane flight, coexistence with thalassemia or hereditary spherocytosis or severe pyruvate kinase deficiency, can precipitate infarction. Interestingly in our first case, the patient with sickle cell trait developed splenic infarction and non-occlusive thrombus in the distal splenic vein after 5-hour flight. It is possible that the hypoxia associated with the commercial flight caused conformational changes in sickle cells, leading to red blood cells sluggish in the splenic red pulp, and eventually leading to splenic infarction. The alcohol binge resulted in dehydration and hemostasis, leading to splenic vein thrombosis, further perpetuating the vicious cycle. Therefore, we recommend adequate hydration and in-flight oxygen supplementation for sickle cell trait patients taking airplane flight. Further studies need to be done to confirm our hypothesis. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Idiopathic Splenic Vein Thrombosis Presenting as Splenic Infarction and Consequent Gastric Variceal Bleeding

2014 ◽  
Vol 3 (2) ◽  
pp. 111
Author(s):  
You-Bin Lee ◽  
Sung Mok Kim ◽  
Jin-Seok Heo ◽  
Hyeri Seok ◽  
In Seub Shin ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Infarction ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

Portomesenteric thrombosis after robotic sleeve gastrectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e236202
Author(s):  
Omkaar Jaikaran ◽  
Derek Lim ◽  
Brian Binetti ◽  
Vadim Meytes
Keyword(s):  
Sleeve Gastrectomy ◽  
Portal Vein ◽  
Methylenetetrahydrofolate Reductase ◽  
Splenic Vein ◽  
Subsequent Development ◽  
Obese Women ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Robotic Sleeve Gastrectomy ◽  
Compound Mutation

Portomesenteric thrombosis is an important but rarely reported complication following bariatric surgery. It has been suggested that the incidence of portal vein thrombosis is directly related to many risk factors inherent in the bariatric population as well as factors related to local and systemic effects of laparoscopic surgery. Possible aetiologies vary from systemic inherited hypercoagulable states to a direct inflammatory reaction of portosystemic vessels. Here we present a case report of a 47-year-old obese women who underwent a robotic sleeve gastrectomy with subsequent development of a main portal vein, complete right intrahepatic portal vein and splenic vein thrombosis ultimately found to have a compound mutation of the methylenetetrahydrofolate reductase C677T and A1298C alleles.

scholarly journals COVID-19 as a trigger for splenic infarction in a patient with sickle cell trait: a case report

2021 ◽  
pp. 100047
Author(s):  
Álvaro Alejandre-de-Oña ◽  
Jaime Alonso-Muñoz ◽  
Pablo Demelo-Rodríguez ◽  
Jorge del-Toro-Cervera ◽  
Francisco Galeano-Valle
Keyword(s):  
Case Report ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Splenic Infarction

scholarly journals Atraumatic splenic rupture precipitated by splenic vein thrombosis

2016 ◽  
Vol 11 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Qiao Zhou ◽  
Chirag Shah ◽  
Jean-Michel Arthus ◽  
Harlan Vingan ◽  
John Agola
Keyword(s):  
Splenic Rupture ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Atraumatic Splenic Rupture
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