Journal of Thrombosis and Thrombolysis

, Volume 38, Issue 2, pp 218–222 | Cite as

Portal vein thrombosis after laparoscopic splenectomy during childhood

  • Thomas Gelas
  • Aurélien Scalabre
  • Frédéric Hameury
  • Rémi Dubois
  • Céline Grosos
  • Pierre D. Mouriquand
  • Pierre-Yves Mure
Article

Abstract

Portal vein thrombosis (PVT) is a rare but potentially life-threatening complication of laparoscopic splenectomy (LS) and can lead to bowel ischemia or portal hypertension. In childhood, this complication is reported in 5–10 % of the cases whereas it can be up to 50 % in adult population. Our aim was to evaluate PVT incidence after LS and associated risks factors. A retrospective chart review identified 37 children who underwent elective LS from 2005 to 2013. The main indications were spherocytosis or sickle cell disease. Median age and weight were respectively 7.4 years and 25.1 kg. Thromboembolic prophylaxis was not routinely given. Duration of surgery was 129 min and hospital length of stay 4 days. Doppler ultrasound scan (USS) was performed post-operatively in 26 cases. Post-operative course was uneventful in all but one patient. She was a 17 year-old girl previously operated for an ovarian tumor with hyperandrogenism. Histopathology revealed a splenic lymphoma. At day 4, a systematic USS showed a PVT extending in the portal branches. Therapeutic low molecular weight heparin was used and then transitioned to fluindione for 3 months. Follow-up USS performed at 1 and 4 months demonstrated complete resolution of the PVT. PVT after pediatric LS is a rare event in our series. Clinician should be cautious in oncologic cases and if very large spleen or if thrombocythemia >650.109/L is present. If detected early, PVT can be treated efficiently. We therefore recommend a systematic USS during the first postoperative week.

Keywords

Pediatric Splenectomy Portal vein thrombosis Splenomegaly Thrombocythemia 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Thomas Gelas
    • 1
  • Aurélien Scalabre
    • 1
  • Frédéric Hameury
    • 1
  • Rémi Dubois
    • 1
  • Céline Grosos
    • 1
  • Pierre D. Mouriquand
    • 1
  • Pierre-Yves Mure
    • 1
  1. 1.Pediatric Surgery DepartmentFemme Mère Enfant Hospital – Hospices Civils de Lyon and Claude Bernard University Lyon 1BronFrance

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