Isolated splenic vein thrombosis.

Isolated splenic vein thrombosis may lead to a specific clinical presentation, namely, bleeding from isolated gastric varices (which are difficult to diagnose), splenomegaly, and normal liver function. The most common cause is pancreatic disease. To exclude associated portal venous thrombosis, angiography is essential prior to a splenectomy, which is curative of the variceal hemorrhage. Splenic vein thrombosis may also be noted as an incidental finding during angiography. Although the natural history is uncertain, a splenectomy is probably not indicated until a hemorrhage occurs.