RT Book, Section A1 Shirley, Lawrence A. A1 Bloomston, Mark A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105291158 T1 SPLENIC VEIN THROMBOSIS T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesscardiology.mhmedical.com/content.aspx?aid=1105291158 RD 2024/03/19 AB A 55-year-old man with a history of chronic alcoholism and recurrent bouts of pancreatitis presented with new onset of hematemesis and hematochezia. He complained of an acute exacerbation of his usual chronic left-sided abdominal pain. Vital signs showed tachycardia with a heart rate of 115 bpm and a blood pressure of 95/62 mm Hg. Physical examination was remarkable for epigastric and left upper quadrant tenderness without stigmata of cirrhosis. Laboratory work was significant for hemoglobin of 7.5 g/dL, a hematocrit of 22.2%, an amylase of 397 IU/L, and a lipase of 264 U/L. Hepatic function panel was within normal limits. After initial resuscitation, upper endoscopy was undertaken, showing actively bleeding gastric varices, but no evidence of esophageal varices. Hemostasis was obtained endoscopically. Subsequent computed tomography (CT) imaging demonstrated an atrophic calcified pancreas with occlusion of the splenic vein, splenomegaly, and multiple perigastric collaterals. No tumor was seen in the pancreas, and there was no evidence of cirrhosis. The patient subsequently underwent a laparoscopic splenectomy prior to discharge. Figures 49-1,49-2,49-3 show representative imaging of a patient with splenic vein thrombosis (SVT).