Portal vein thrombosis post-splenectomy in thalassemia major patients

  • Kussay M. Abbas Zwain Department of Surgery, Faculty of Medicine, Kufa University, Najaf city, Iraq
  • Samer M. Mohamed Al-Hakkak Department of Surgery, Faculty of medicine, Jabir Ibn Hayyan Medical University, Najaf city, Iraq
  • Alaa A. Al-Wadees Department of Surgery, Faculty of medicine, Jabir Ibn Hayyan Medical University, Najaf city, Iraq
  • Zainab Mahdi Majeed Department of surgery, AL-Sader teaching Hospital, Ministry of Health, Najaf city, Iraq

Abstract

β-thalassemia major is a chronic, inherited hematological disease that leads to chronic anemia in the affected children. One of the options of treatment in such patients was splenectomy; however, it is not without risk of many complications; one of them is the thrombotic events. A prospective study of 55 patients with β-thalassemia inscribes in this study. 14 patients (25.5%) had a normal thrombocyte count and 41 patients (74.5%) have an abnormally high thrombocytes count which was significantly associated with PVT (P. Value <0.001), Regarding the WBC count, it extended between 4000 to more than 30,000, in both genders with non-statistically significant differences between both genders, (P>0.05). Regarding the serum ferritin, the mean level was 2908.5 ± 1024.3 ng/ml. In males, the mean S. Ferritin was relatively higher than that of females, 3167.6 ± 1841.3 mg/dl, and 2573.8 ± 1150.6 ng/ml. The weight of the spleen was up to 1500 grams in 25 (80.6%) of males and 20 (83.3 %) of females while it was more than 1500 grams in the remaining and females and males, without a significant difference statistically in the spleen weight of, (P>0.05). The most frequent presenting symptom was abdominal pain. It was founded in 46 patients (83.6%), followed by fever in 76.4%, diarrhea in 58.2%, and Nausea and vomiting in 31 (56.4%). 3 patients out of the 55 (5.5%) developed portal vein thrombosis in their follow up period. Post splenectomy PVT in thalassemia the patient is relatively frequent (5.5%) complication that require a high degree of doubt for diagnosis early, especially in patients with postoperative pain of the abdomen within 2 months after surgery, Female gender, Large spleen and postoperative increase number of platelets are risk factors for PVT so one can initiate surveillance by Doppler ultrasound postoperatively and start antiplatelet prophylactic therapy immediately for such patients. 

Keywords: portal vein thrombosis (PVT), beta-thalassemia, splenectomy, complication

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Published
2019-10-16
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How to Cite
Kussay M. Abbas Zwain, Samer M. Mohamed Al-Hakkak, Alaa A. Al-Wadees, & Zainab Mahdi Majeed. (2019). Portal vein thrombosis post-splenectomy in thalassemia major patients. International Journal of Research in Pharmaceutical Sciences, 10(4), 3356-3368. https://doi.org/10.26452/ijrps.v10i4.1645
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Original Articles
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