Isolated Splenic Vein Thrombosis

Glynn, Michael

doi:10.1001/archsurg.1986.01400060119018

Cited by 58 publications

(38 citation statements)

References 27 publications

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“…As in the present case, however, the appropriate treatment of asymptomatic patients remains controversial. 8 Loftus et al, in their retrospective study, concluded that neither survival nor new or recurrent bleeding differed between patients treated with splenectomy and those who were only observed. 9 Sarin et al, however, reported in their prospective study that isolated gastric varices had a higher rate and larger amount of gastrointestinal bleeding than esophageal varices.…”

Section: Discussionmentioning

confidence: 97%

Splenic Vein Occlusion Secondary to Tuberculous Lymphadenitis at the Splenic Hilum: Report of a Case

et al. 2000

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We report a patient with splenic vein occlusion (SVO) secondary to tuberculosis. A 17-year-old male patient with mild epigastric pain and splenomegaly was found to have gastric varices by gastroscopy, and SVO by selective angiography. At operation, the splenic vein was occluded by hard fibrous tissue at the splenic hilum, and thus a splenectomy was performed. A microscopic examination of the tissue revealed caseous necrosis surrounded by epithelioid cells and Langhans-type giant cells. Although there were no other findings suggesting intestinal tuberculosis, it seemed that tuberculous lymphadenitis of the splenic hilum most likely caused the occlusion of the splenic vein. Because specific tests for tuberculosis were negative in both immunohistochemical staining for bacille Calmette-Guérin and polymerase chain reaction of DNA for Mycobacterium tuberculosis, the time of infection was assumed to have occurred a long time before. SVO can sometimes be seen in pancreatic diseases, but this patient with tuberculosis appears to be the first such reported case in the English literature.

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Section: Discussionmentioning

confidence: 97%

Splenic Vein Occlusion Secondary to Tuberculous Lymphadenitis at the Splenic Hilum: Report of a Case

et al. 2000

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“…It is a localized form of portal hypertension that occurs as a result of isolated thrombosis or obstruction of the splenic vein [7,8]. The features distinguishing it from other forms of portal hypertension are preserved liver function and a patent extrahepatic portal vein [1].…”

Section: Discussionmentioning

confidence: 99%

Severe intestinal bleeding due to sinistral portal hypertension after pylorus-preserving pancreatoduodenectomy

et al. 2009

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“…Angiography (either in the form of SPVG or arterioportography) is the most reliable technique to document the presence of these varices [3] and define the exact nature of the portal obstruction (intra-or extrahepatic). It however remains an invasive test that is usually employed after gastric varices are suspected on other noninvasive tests.…”

Section: Discussionmentioning

confidence: 99%

“…The accuracy of barium studies for detecting IGV ranges from 14-74% [1, 2] depending upon the radiologic criteria used to make the diagnosis. The reliability of endoscopy in diagnosing gastric varices, though poorly documented, is far from satisfactory [3]. Until recently splenoportovenography (SPVG) has been the investigation of choice for detecting isolated gastric varices, as well as for demonstrating its etiology.…”

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confidence: 99%

Isolated gastric varices: Ultrasound detection

Malde¹,

Kedar²,

Chadha³

1993

Abdom Imaging

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Abstract. Isolated gastric varices (IGV) (resulting from varying etiologies) were diagnosed in six patients using ultrasound examination of the wall of the fluid-filled stomach. Small gastric varices are seen as circular or linear anechoic channels within the gastric wall without a significant intraluminal projection. Large varices are seen as anechoic, lobulated "bulging masses" projecting into the fluid-filled lumen of the stomach. Doppler technique assists in confirming the vascular nature of these lesions and thus avoids confusion with other hypoanechoic lesions of the gastric wall. The technique is simple, noninvasive, and extremely useful in diagnosing IGV in patients investigated for recurrent undiagnosed gastrointestinal bleeding.Key words: Isolated gastric varices, US--Doppler techniques.The detection of isolated gastric varices (IGV) remains a diagnostic challenge. The accuracy of barium studies for detecting IGV ranges from 14-74% [1, 2] depending upon the radiologic criteria used to make the diagnosis. The reliability of endoscopy in diagnosing gastric varices, though poorly documented, is far from satisfactory [3]. Until recently splenoportovenography (SPVG) has been the investigation of choice for detecting isolated gastric varices, as well as for demonstrating its etiology. However, it is slowly being replaced by less invasive procedures, such as arterioportography [4]. Although IGV have been detected on computed tomography (CT) [5], its high cost, poor accuracy, and the use of ionizing radiation make it unsuitable for screening patients suspected of having isolated gastric varices. We describe a new technique employing the fluidfilled stomach as a window to detect IGV aided by flow detection through the Doppler technique. Materials and MethodsBetween October 1990 and June 1991, IGV were diagnosed in six patients (four males and two females) at our institution. These patients ranged from 12-58 years in age. Four of the six patients were investigated for recurrent undiagnosed gastrointestinal bleeding, whereas the other two had splenomegaly. Causes for the IGV in these patients included portal vein thrombosis (two patients), splenic vein thrombosis (two patients), noncirrhotic portal fibrosis (one patient), and liver cirrhosis (one patient).Real-time sonography was performed in all patients using a variety of convex and sector transducers ranging in frequency from 3.5-7.5 MHz (Sonoline AC, Siemens Inc. Ltd). In all patients, duplex Doppler sonography was performed using the same equipment. Detection of these variceal channels within the gastric wall was facilitated by employing the technique advocated by others to assist detection of gastric wall [7] and pancreatic head lesions [8] using the fluid-filled stomach as a sonographic window.Apart from abdominal sonography, endoscopic examination of the esophagus and stomach was performed in all patients. The presence of the IGV detected on abdominal sonography was confirmed by a SPVG in all patients.After a routine upper abdominal sonography, the fasting...

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Isolated Splenic Vein Thrombosis

Cited by 58 publications

References 27 publications

Splenic Vein Occlusion Secondary to Tuberculous Lymphadenitis at the Splenic Hilum: Report of a Case

Splenic Vein Occlusion Secondary to Tuberculous Lymphadenitis at the Splenic Hilum: Report of a Case

Severe intestinal bleeding due to sinistral portal hypertension after pylorus-preserving pancreatoduodenectomy

Isolated gastric varices: Ultrasound detection

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