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创伤性脾切除术后右门静脉血栓形成

Right portal vein thrombosis after splenectomy for trauma.

作者信息

Stella Mattia, Serventi Alberto, Friedman Daniele

机构信息

Department of Surgery, School of Medicine (DICMI), Genoa, Italy.

出版信息

J Gastrointest Surg. 2005 May-Jun;9(5):646-7. doi: 10.1016/j.gassur.2004.09.059.

Abstract

Portal vein thrombosis may complicate splenectomy in patients with hemolytic anemia and myeloproliferative disease, whereas the frequency of portal vein thrombosis in case of trauma is not defined. A case of right portal vein thrombosis after splenectomy for trauma is reported in this paper. Hematologic workup did not reveal an underlying platelet or coagulation disorder. The patient was promptly anti-coagulated with complete recanalization of the portal vein. We conclude that mild symptoms, like abdominal pain and fever, after splenectomy should be investigated with a color Doppler ultrasonography to confirm or rule out a diagnosis of portal thrombosis and to anti-coagulate the patient with thrombosis, thus preventing bowel infarction and secondary portal hypertension. Routine postoperative color Doppler might also be justified in all postsplenectomy patients (without hematologic diseases) for early detection of a portal vein thrombosis.

摘要

门静脉血栓形成可能使溶血性贫血和骨髓增殖性疾病患者的脾切除术后出现并发症,而创伤情况下门静脉血栓形成的发生率尚无定论。本文报道了1例因创伤行脾切除术后发生右门静脉血栓形成的病例。血液学检查未发现潜在的血小板或凝血障碍。患者立即接受抗凝治疗,门静脉完全再通。我们得出结论,脾切除术后出现的腹痛和发热等轻微症状,应通过彩色多普勒超声检查来确诊或排除门静脉血栓形成的诊断,并对有血栓形成的患者进行抗凝治疗,从而预防肠梗死和继发性门静脉高压。对于所有脾切除术后患者(无血液系统疾病),常规术后彩色多普勒检查也可能有助于早期发现门静脉血栓形成。

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