Splenectomy for en bloc node dissection in gastric cancer: a possible cause of portal vein thrombosis.

M Kogire, O Nishida, H Kobayashi, T Shimogou, F Izumi, A Sugiyama, J Ida, A Mori, J Tamura, M Koumoto, N Baba, H Ogawa, S Sakanashi
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Abstract

A 48-year-old woman underwent total gastrectomy, splenectomy, and distal pancreatectomy with en bloc regional lymph node dissection for gastric carcinoma. Dull pain in the right upper quadrant and the back developed postoperatively. Contrast-enhanced computed tomography and ultrasonography disclosed portal vein thrombosis (PVT). Heparin and urokinase were given in conjunction with antibiotics. This treatment resulted in clinical improvement, but failed to achieve complete thrombolysis. Cavernous transformation of the portal system was confirmed. Although PVT after splenectomy has been reported mainly in patients with hematological disorders, our case suggests that splenectomy for en bloc node dissection in gastric carcinoma is a possible cause of PVT.

胃癌脾切除整块淋巴结清扫术:门静脉血栓形成的可能原因。
一位48岁的女性因胃癌接受了全胃切除术、脾切除术和远端胰腺切除术并整体区域淋巴结清扫。术后右上腹及背部出现钝痛。对比增强计算机断层扫描和超声检查显示门静脉血栓形成(PVT)。肝素和尿激酶与抗生素联合使用。这种治疗导致临床改善,但未能实现完全溶栓。传送门系统的海绵状转变已被证实。虽然脾切除术后PVT主要发生在血液系统疾病患者中,但我们的病例提示胃癌脾切除术后整体淋巴结清扫可能是PVT的一个原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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