Splenic vein thrombosis and gastrointestinal bleeding in chronic pancreatitis.

The most common cause of isolated thrombosis of the splenic vein is chronic pancreatitis caused by perivenous inflammation. Although splenic vein thrombosis (SVT) has been reported in up to 45% of patients with chronic pancreatitis, most patients with SVT remain asymptomatic. In those patients with gastrointestinal bleeding secondary to esophageal or gastric varices, the diagnostic test of choice to assess for the presence of SVT is late-phase celiac angiography. Splenectomy effectively eliminates the collateral outflow and is the treatment of choice. Other underlying pathology, such as pseudocysts, can be treated at the same time.