scholarly journals Floating spleen with chronic torsion of the pedicle causing splenomegaly and secondary hypersplenism

2004 ◽  
Vol 132 (9-10) ◽  
pp. 327-330 ◽  
Author(s):  
Radoje Colovic ◽  
Darinka Boskovic ◽  
Nikica Grubor ◽  
Natasa Colovic
Keyword(s):  
Blood Cells ◽  
Splenic Vein ◽  
Venous Stasis ◽  
Lower Abdomen ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Immediate Surgery ◽  
Splenic Pedicle ◽  
Accessory Spleens ◽  
Early Surgical Treatment

If the spleen is not fixed within the left subphrenic space, it gradually passes into the lower abdomen, where is much more exposed to trauma. Torsion of the splenic pedicle can also occur, causing the infarct necessitating an immediate surgery. Venous stasis causes splenomegaly and sometimes secondary hypersplenism. The authors present 16.5-year old girl with torsion of the splenic pedicle of floating spleen for 720?: in spite of that, the patient had neither splenic infarct nor splenic vein thrombosis, possibly due to thrombocytopenia, but she had splenomegaly and secondary hypersplenism with pancytopenia causing bleeding, sideropenic anemia and mild jaundice. After treatment with iron, the patient underwent splenectomy which resulted in almost immediate rise of the number of all blood cells, and even thrombocytosis. The authors suggest early surgical treatment of the floating spleen, preferably splenopexy, before development of severe complications when splenectomy had to be performed in the majority of patients. Accessory spleens, if present, should be saved.

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 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

Splenic Vein Thrombosis an Unusual Case of Gastric Bleeding

Angiology ◽  
1977 ◽  
Vol 28 (10) ◽  
pp. 725-727 ◽  
Author(s):  
A. Haye Khan ◽  
C.J. O'Reilly ◽  
V.A. Avakian ◽  
P.A. Lucina
Keyword(s):  
Unusual Case ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Gastric Bleeding ◽  
Vein Thrombosis

scholarly journals Heparin-induced thrombocytopenia presenting as splenic hemorrhage following cardiac surgery: a case report

2020 ◽  
Author(s):  
Joseph F. Ferry ◽  
Samuel Youssef ◽  
Pierce Wu ◽  
Livia Hegerova
Keyword(s):  
Emergency Department ◽  
Cardiac Surgery ◽  
Splenic Vein ◽  
Adrenal Hemorrhage ◽  
Right Atrial ◽  
Splenic Vein Thrombosis ◽  
Heparin Induced Thrombocytopenia ◽  
Vein Thrombosis ◽  
Bilateral Adrenal Hemorrhage ◽  
The Right

Abstract Background: Heparin-induced thrombocytopenia with thrombosis (HITT) is a paradoxical prothrombotic complication of anticoagulant therapy. As many as 3% of patients undergoing cardiac surgery develop clinical HIT presenting as thrombocytopenia with or without thrombosis within 5-10 days of heparin exposure. Thrombotic complications associated with HIT carry a mortality rate of 5-10%.Case presentation: We report a case of atraumatic splenic hemorrhage due to splenic vein thrombosis as the main indicator of HIT following cardiac surgery in a 62-year-old woman. She presented to the emergency department on day nine following coronary artery bypass graft surgery with acute weakness, dizziness, and malaise. Her evaluation in the emergency department found anemia and thrombocytopenia. A coagulation profile revealed a markedly elevated d-dimer. She underwent a computed tomography scan of the chest, abdomen and pelvis for suspected bleed and was found to have splenic vein thrombosis, right atrial filling defects consistent with atrial thrombus and mild to moderate hemoperitoneum. Surgical consultation was obtained due to splenic hemorrhage. Hematology was consulted on post-operative day 10, however, she unfortunately developed left sided weakness concerning for stroke. A magnetic resonance imaging scan of the brain demonstrated infarct involving distribution of the right anterior cerebral artery. A transesophageal echocardiogram demonstrated a large immobile thrombus within the right atrium with a second, mobile thrombus arising from the left tricuspid valve annulus. Due to a 4Ts score of 7 and markedly positive platelet factor 4 (PF4) IgG antibody a serotonin release assay was not performed given the high probability of HIT. She was cautiously treated with bivalirudin and was transitioned to warfarin anticoagulation. In the following days her platelet count recovered and 3 months later a transthoracic echocardiogram revealed solution of the intracardiac thrombi.Conclusions: Atraumatic splenic hemorrhage is an unusual presentation of HIT that is reminiscent of the rare bilateral adrenal hemorrhage due to adrenal necrosis that also occurs in HIT. Alternative anticoagulation is the mainstay of therapy for HIT despite hemorrhage, given the underlying acquired hypercoagulability. Despite similarities of the presentation between splenic hemorrhage and bilateral adrenal hemorrhage, splenic hemorrhage is rarely described in the literature. HIT should be considered in patients presenting with thrombocytopenia following cardiac surgery.

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