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.
