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Eur J Pediatr Surg 2005; 15(5): 358-360
DOI: 10.1055/s-2005-865755
Case Report

Georg Thieme Verlag KG Stuttgart, New York · Masson Editeur Paris

Acute Portal Vein Thrombosis after Splenic Embolization and Splenectomy for Autoimmune Pancytopenia

J. Nounla1 , I. Sorge2 , F. Deckert2 , H. Lenk3 , R. B. Tröbs1
  • 1Clinic of Pediatric Surgery, University of Leipzig, Leipzig, Germany
  • 2Clinic of Diagnostic Radiology, University of Leipzig, Leipzig, Germany
  • 3Clinic of Pediatrics, University of Leipzig, Leipzig, Germany
Further Information

Publication History

Received: February 15, 2004

Accepted after Revision: July 8, 2004

Publication Date:
28 October 2005 (online)

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Abstract

Postsplenectomy portal vein thrombosis for hematological diseases is uncommon in the pediatric population. The case summarized is, to our knowledge, the first manifestation of portal vein thrombosis in a child after preoperative splenic artery embolization and subsequent splenectomy for severe hypersplenism. We suggest that early routine diagnosis by Doppler ultrasonography and subcutaneous low molecular weight heparin therapy are useful steps for a successful outcome.

Résumé

La thrombose de la veine portale post-splénectomie pour des désordres hématologiques est inhabituelle chez l'enfant. Le cas résumé ici est, à notre connaissance, la première manifestation d'une thrombose de la veine portale chez un enfant après embolisation préopératoire de l'artère splénique et splénectomie seconde pour hypersplénisme sévère. Nous suggérons que le diagnostic précoce soit réalisé par échographie Doppler et que l'héparine de bas poids moléculaire soit utilisée pour un devenir favorable.

Resumen

La trombosis portal post-esplenectomía por indicación hematológica es poco común en niños. El caso que presentamos es, que nosotros sepamos, el primero de trombosis de la vena porta en un niño tras embolización esplénica arterial preoperatoria y esplenectomía ulterior por hiperesplenismo severo. Sugerimos que el diagnóstico rutinario temprano por ultrasonografía doppler y la heparina subcutánea de bajo peso molecular son pasos útiles en este proceso.

Zusammenfassung

Die Pfortaderthrombose nach Splenektomie bei Kindern mit hämatologischen Erkrankungen ist eine ungewöhnliche Komplikation. Der Fallbericht schildert die Manifestation einer ausgeprägten Pfortaderthrombose nach Splenektomie und präoperativer Embolisation der Milzarterie bei einem Adoleszenten. Der klinische Verlauf war nicht wegweisend. Spezifische abdominelle Symptome lagen nicht vor. Wir befürworten den frühzeitigen Einsatz der Dopplersonographie und die subkutane Gabe von niedermolekularem Heparin zur Früherkennung bzw. Prophylaxe.

Key words

Splenectomy - portal vein thrombosis - embolization - ultrasonography

Mots-clés

Splénectomie - thrombose de la veine portale - embolisation échographie

Palabras clave

Esplenectomía - trombosis de la porta - embolización - utrasonografía

Schlüsselwörter

Splenektomie - Pfortaderthrombose - Embolisation - Ultraschall

References

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Dr. J. Nounla

Clinic of Pediatric Surgery
University of Leipzig

Oststraße 21 - 25

04317 Leipzig

Germany

Email: nouj@medizin.uni-leipzig.de