Splenic vein thrombosis historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]Sunny Kumar MD [3]

Thrombosis of the splenic vein is infrequently reported in literature, it is common knowledge among surgeons that this condition may follow splenectomy. In fact, local thrombosis at the site of ligation of the splenic artery and vein with extension back to the first branching vessel is to be expected after splenectomy. This degree of involvement of the splenic vein, however, should be asymptomatic, but it is potentially important because of possible extension into the portal venous system and as a source of emboli to the liver.

Thrombosis of the splenic vein is infrequently reported in literature, articles were published in the New England journal of medicine in the late 1940’s. Benjamin et al described cases of splenic vein thrombosis following trans thoracic gastrectomy and incidental splenectomy.

• In the year 1952, percutaneous splenoportography was first described by Dreyer and Bandtz which helped to increase the discovery rate of causes of splenic vein thrombosis.
• In the year 1956, three cases of splenic vein thrombosis were diagnosed by percutaneous splenoportography among 36 splenectomies done at Ohio State University hospitals for hematologic cases.
• In the year 1951 a german article cited cases of portal embolism following thrombosis of splenic vein and causing infarct like cyanotic atrophy(‘Zahn’s infarcts’) of the liver, as a complication of splenectomy in the course of total gastrectomy.
• In 2016, atypical cases of splenic vein thrombosis were reported in patients with epigastric pain whose initial diagnosis was presumed to be gastritis but later were diagnosed as having biopsy-proven pancreatic cancer.^[1]
• Spleno-portal thrombosis accompanying complications of Banti’s disease has been reported in 1960’s.
• In 1970s, cases of splenic vein thrombosis secondary to pancreatic disease have been reported.
• In 1990s, Weber Christian disease producing splenic vein occlusion and bleeding gastric varices and it’s successful treatment with sclerotherapy was described in British Medical Journal.^[2]
• In early 2000s splenic vein thrombosis has been reported in pediatric sickle cell disease and splenic vein thrombosis secondary to mutation of prothrombin gene has been reported.^[3]
• In late 2000s, cases of splenic vein thrombosis associated with antiphospholipid antibodies in a patient with wegener’s granulomatosis has been reported.^[4]