Splenic vein thrombosis means that the vein which drains the spleen develops a blockage from a clot. This condition is most commonly associated with diseases of the pancreas like pancreatitis and pancreatic cancer. It can also occur with other cancers, trauma and states which make you prone to blood clots.
Splenic vein thrombosis can be asymptomatic at times but is dangerous because it can lead to bleeding from the stomach related to varices. Imaging with ultrasound, CT and MRI plays a key role in diagnosis. Trestment with removal of the spleen is offered to patients who develop bleeding from the stomach.
What is a splenic vein thrombosis?
Splenic vein thrombosis is a blockage of the splenic vein from a clot. The splenic vein drains the spleen.
Symptoms of splenic vein thrombosis
This condition can be asymptomatic. Some patients can develop an enlarged spleen and abdominal pain. The most feared complication is a bleed from the stomach which can be life threatening. Many patients have associated pancreatitis or cancer.
How is splenic vein thrombosis diagnosed?
Splenic vein thrombosis is seen on imaging tests like ultrasound, CT, MRI.
What does splenic vein thrombosis look like on imaging?
Splenic vein thrombosis may result in a partial or complete blockage.
Splenic vein thrombosis on ultrasound may reveal a dilated splenic vein with internal clot and reduced or absent color flow.
CT and MRI with contrast will reveal an occluded vein or one that has a clot inside. We may also see collateral vessels which go around the blockage.
What else can look like splenic vein thrombosis in radiology?
Splenic vein thrombosis is characteristic on imaging. There is little confusion in the diagnosis. We may also identify why the vein is thrombosed in many cases. This can be from diseases of the pancreas such as pancreatitis or cancer.
What causes splenic vein thrombosis?
The splenic vein lies in close proximity to the pancreas and is suspectible to thrombosis from diseases of the pancreas.
The most common cause is chronic pancreatitis. This is a chronic inflammatory and scarring process of the pancreas. Patients with pancreatic cancer are also susceptible to splenic vein thrombosis when the tumor lies in proximity to the splenic vein.
Other conditions which predispose patients to blood clots can also contribute to splenic vein thrombosis. Blood disorders, having cancer, being on oral contraceptives are some other predisposing factors.
Is splenic vein thrombosis dangerous?
It can be because the blockage of the splenic vein can lead to rurpture of collateral vessels in the stomach and dangerous bleeding. The collateral vessels in the stomach are a way for boood to bypass the blockage in the splenic vein.
What type of doctor treats splenic vein thrombosis?
Both internal medicine doctors and surgeons can treat splenic vein thrombosis.
Splenic vein thrombosis treatment
Thrombosis of the splenic vein may involve no treatment for asymptomatic patients. Treatment with blood thinners (anticoagulants) in some cases to help clear the clot. Surgery is mostly reserved for patients who have varices in the stomach and bleeding.
Splenic vein thrombosis: summary
Splenic vein thrombosis is a blockage of the vein from clot. This often develops in patients who have diseases of the pancreas such as pancreatitis. This is because the splenic vein lies in close proximity to the pancreas.
Splenic vein thrombosis is diagnosed on imaging tests. We may also see why the vein is thrombosed in some cases. Many patients are without symptoms. The most feared complication is bleeding from collateral vessels in the stomach. These patients will benefit from removal of their spleen.