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At least 19 recordsLinked to original sources
PubMedDate not supplied

Hemodynamic and morphologic evaluation of the spleen after splenic vein ligation in the dog.

The splenic vein was ligated in ten dogs in order to evaluate the time course of changes in splenic size and to relate them to splenic arterial flow, splenic pressure and development of venous collaterals. Following ligation of the splenic vein, splenic size and venous pressure immediately rose in all dogs. Arterial flow to the spleen simultaneously fell in roughly inverse proportion to the elevation of venous pressure. During the following weeks, the splenic parenchymal pressure decreased to basline levels in all but one dog, as collateral veins developed through the gastric venous network to the portal vein. Splenic size gradually decreased toward normal in eight of the ten dogs. At the time of sacrifice, 8-16 weeks after splenic vein ligation, pathologic examination demonstrated fibrosis from healed infarction. Recent hemorrhage, indicating persistence of the congestive process, we also present, although difficult to explain in view of normal splenic parenchymal pressure.

Animals↗
PubMedDate not supplied

Splenic vein thrombosis in patients with a normal size spleen.

The frequency of splenic vein obstruction secondary to pancreatic or retroperitoneal diseases has been only recently appreciated. The diagnosis is important because it frequently results in development of gastric and duodenal varices. It is often assumed that the diagnosis should only be suspected in patients with splenomegaly. This report describes 19 patients in whom splenic vein thrombosis was diagnosed by angiography although clinically unsuspected. In 11, the spleen was normal in size although extensive gastric varices were present. In 3 patients the presenting problem was massive hematemesis. Review of the upper gastrointestinal examinations in these patients showed thickened gastric or duodenal folds although in the absence of esophageal varices, the diagnosis was not made prior to angiography. More liberal use of angiography in patients with an appropriate clinical background, such as a history of pancreatitis, may lead to earlier and more frequent diagnosis of splenic vein obstruction. Varices that result from splenic vein obstruction can be cured by splenectomy.

Cystadenoma↗
PubMed1978

Recognition of splenic vein occlusion.

Radiologic findings and medical records of 27 patients with angiographic documentation of splenic vein occlusion were reviewed. The most common causes were pancreatic carcinoma, pancreatitis, and malignant lymphoma. Radiographic findings which suggest splenic vein occlusion are gastric varices without esophageal varices and collateral veins in the left upper abdomen during the vascular phase of rapid sequence pyelography. Additional features may be associated with the underlying disease, such as pancreatic calcification and upper abdominal mass lesions. The diagnosis is usually confirmed by high dose celiac or splenic angiography. Examination of the stomach with barium for the detection of gastric varices is more sensitive than has been previusly recognized; features which suggest them are described. Isolated gastric varices may be a clue to isolated splenic vein occlusion and its underlying causes.

Adult↗
PubMed1978

Colonic varices. A complication of pancreatitis with splenic vein thrombosis.

A patient with recurrent gastrointestinal bleeding was found to have varices at the splenic flexure at colonoscopy. Angiography revealed complete occlusion of the splenic vein. Although the patient did not have cirrhosis, he did have a history of pancreatitis which presumably was responsible for the splenic vein thrombosis. This case represents a compartmentalized form of portal hypertension which requires careful endoscopic and radiographic studies for proper evaluation. Successful treatment was accomplished by splenectomy.

Colon↗
PubMed1979

Gastric varices secondary to splenic vein occlusion: radiographic diagnosis and clinical significance.

The radiographic appearance and clinical significance of gastric varices in the absence of esophageal varices and secondary to splenic vein occlusion were studied. Eighteen patients were evaluated through medical records, angiography, and barium studies of the stomach and esophagus. The presence of splenic vein occlusion was determined by arteriography in 18 patients and its etiology confirmed by surgery in 17 patients. This condition should be suspected in patients with chronic abdominal pain, weight loss, and iron deficiency anemia who show fundal polypoid filling defects or prominent gastric folds on an upper GI series.

Adult↗
PubMed1978

An unusual case of portasystemic encephalopathy caused by splenic vein occlusion following gastrectomy.

A patient with recurrent episodes of consciousness disturbance following partial gastrectomy is presented. Angiographic examination revealed a great portasystemic shunt, which probably developed following the postoperative splenic vein thrombosis. This is suspected a rare cause of the condition. In chronic liver disease, recurrent encephalopathy which is caused by portasystemic shunt is well known as one of the most frequent complications. It is very uncommon in adults, however, when the liver is not concerned in the shunt formation. In the present paper the authors report an unusual case of recurrent consciousness confusion which is due to the great portasystemic shunt probably caused by postgastrectomy splenic vein thrombosis.

Cognition Disorders↗
PubMed1977

Splenic vein thrombosis: an unusual case of gastric bleeding.

Acute and/or recurrent gastrointestinal bleeding due to ruptured gastric varices from an isolated thrombosed splenic vein is a distinct entity. Incidence of this syndrome is probably less than 1%. Typical clinical features of this syndrome include evidence of splenic hypertension without liver disease and no demonstrable cause of gastrointestinal hemorrhage. Diagnosis can easily be missed unless the surgeon is familiar with this syndrome. Typical findings at the time of surgery are an enlarged spleen, varicose veins usually involving the upper third of the stomach, and pancreatic and peripancreatic inflammation. Portal vein and portal pressure will be normal. Meso-portography is a convenient and safe procedure and will lend support to suspicion when a retrograde nonfilling of the splenic vein is present. Splenectomy offers the expectation of a long-range cure. A representative case of a 39-year-old man is discussed. He had at least six episodes of gastric bleeding in less than 3 years. At a previous laparotomy, the cause of bleeding could not be determined. A splenectomy in December 1970 has been able to control the gastric bleeding since then.

Adult↗
PubMed1975

[Scintigraphic findings in splenic vein thrombosis].

After a brief review of the literature concerning scintigraphy of the spleen, its vascular system is described. The presence of numerous anastomoses makes it likely that occlusion of the splenic vein will usually not lead it any parenchymal damage. In five patients with angiographically confirmed spenic vein thrombosis it was shown that radio-colloid scans always demonstrate an enlarged spleen. Poor colloid uptake was thought to be due to a venous reflex mechanism leading to a reduction in the arterial blood supply. The statement found in the literature, that the spleen cannot be shown scintigraphically if the vein is thrombosed, has not been confirmed by us. We tend to the view that the apparent absence of a splenic scan was due to geometric causes.

Adult↗
PubMed1979

[Coloportal fistula in ulcerative colitis (massive penetration, through the splenic vein, of barium and air into the portal system during barium enema)].

The authors describe one case of massive penetration of barium and air through the splenic vein into the portal system during administration of a radiopaque enema to a woman suffering from hemorrhagic proctitis in the florid phase. They provide a detailed description of this rare clinical case and discuss the possible etiology and pathophysiology of the observed event.

Barium Sulfate↗
PubMed1977

[Splenic arterial aneurysm rupturing into the splenic vein. A rare cause of acute fortal hypertension in the post-partum period (author's transl)].

Following the sudden onset of a clinical syndrome of acute portal hypertension in a young woman in the course of childbirth, angiography revealed a voluminous aneurysm of the splenic artery rupture into the splenic vein. Surgical treatment was successful. The authors review the main characteristics of splenic arterio-venous fistulae and discuss the physiopathological problems of portal hypertension associated with such lesions.

Adult↗
PubMed1976

Bulbous splenic vein as a cause of renal pseudotumor.

A number renal and suprarenal pseudotumors have been described during the past two decades, paralleling the development of selective visceral angiography. An apparent left upper pole renal mass in a 71-year-old hypertensive man was found to ba a bulbous portion of the splenic vein during angiography. The anatomical basis of this renal pseudotumor is discussed.

Aged↗