Trends and results in actual treatment of splenoportal postsplenectomy trombosis

Abstract

Introduction. The splenoportal venous thrombosis axle (TAVS) postplenectomy has an important role in general morbidity. There is still no common decision on the current treatment scheme. Purpose: To identify dynamically clinical-imagistic changes in the evolution of TAVS. Material and methods. In our study were included 74 splenectomized cirrhotic patients. For the 41 studied patients, we applied a strategy to prevent the occurrence of TAVS, namely: fraxiparin / peroxide cleanser, as prophylactic doses. We evaluated factors associated with treatment outcomes Results. 11 patients (14.8%) were diagnosed with TAVS after post-splenectomy, 5 men and 4 women with an average age of 42.3 ± 3.5 years. Approximate time from splenectomy was 6 months (1-13 months). TAVS patients used as therapy antiplatelet-dual-anticoagulant medication, in addition to the complex use of low molecular weight heparins also included oral administration of a platelet antiaggregant (150 mg ticlid, nugrel, plavix, clopidogrel 75 mg, aspirin). Decisions on time and duration of administration were taken on a case-by-case for each patient. The protocal analysis shows a positive response in 82% of cases that shows a amelioration of post-operative thrombocytosis, increasing the speed and volume of portal flow. Post-treatment retromyosis within 6 months was present in 2/11 patients. Conclusion. Factors that influenced the incidence of TAVS after postplenectomy were: significant splenomegaly, functional thrombocytosis, child score, perioperative prophylactic treatment.