Curbside Consultation of the Pancreas: 49 Clinical Questions

Scott Tenner, MD, MPH; Alphonso Brown, MD, MS Clin Epi; Frank Gress, MD

Question 15: My Patient With Acute Pancreatitis Has A Computed Tomography Scan With Thrombosis Of The Splenic Vein. Is It Safe To Anticoagulate Him? (continued)

Susan Ramdhaney, MD; Alphonso Brown, MD, MS Clin Epi

Isolated thrombosis of the splenic vein occurs as a result of left-sided portal hypertension and due to complications from acute and chronic pancreatitis, pancreatic cancer, adenopathy from metastatic cancer, or from iatrogenic causes such as splenectomy, partial gastrectomy, and distal splenorenal shunt. As a complication of chronic pancreatitis, which occurs in 3% to 5% of cases, it should be suspected in patients with a history of pancreatitis and gastrointestinal blood loss; a patient with splenomegaly in the absence of portal hypertension, cirrhosis, or hematologic disease; and in the…