Retrospective study of the incidence of portal vein thrombosis after splenectomy in hematological disorders: Risk factors and clinical presentation.

OBJECTIVE: Portal vein thrombosis (PVT) has been described as a rare complication after splenectomy. PVT associated risk factors after splenectomy in hematological disorders are poorly recognized. The aim of this study was to assess the prevalence and risk factors of PVT incidence in splenectomized patients. METHODS: One hundred twelve splenectomized patients with various hematologic diseases between 2008 and 2018 were enrolled in this study. Diagnosis was confirmed by Doppler ultrasonography (DUSG) and risk factors for PVT were sought based on the comparison of clinical and laboratory features between patients without and with PVT. RESULT: PVT was diagnosed in 4 (3.57%) patients in spite of receiving antiplatelet therapy. Patients with PVT were ß-thalassemia major (n = 2) and ß-thalassemia intermedia (n = 2). ß-thalassemia patients had a 3.5 times higher odds for PVT (95% CI: 2.41-5.33). No significant differences between patients with and without PVT in terms of age, gender and laboratory features were found. CONCLUSION: According to our data, ß-thalassemia, especially intermediate form, may be a risk factor for PVT and it can occur in spite of receiving antiplatelet therapy. Given that ß-thalassemia patients are at risk, early PVT detection may be useful for reduction of fatal PVT complication in splenectomized patients.

A firearm bullet lodged into the thoracic spinal canal without vertebral bone destruction: a case report.

INTRODUCTION: Firearm injuries account for 13% to 17% of all spinal cord injuries, and are generally caused during warfare or assault with intent to kill. Spinal cord injuries caused by firearms are usually observed in patients aged 15 to 34 years old, and are especially common among men. CASE PRESENTATION: We report the case of a 28-year-old Iraqi man who was referred to our radiology department with lower limb paraplegia secondary to a gunshot wound. We performed 64-slice computerized tomography with two-dimensional and three-dimensional reconstruction of the thoracolumbar spine. On the two-dimensional and three-dimensional reconstructed axial images of the thoracolumbar spine, an intra-canalicular bullet nucleus was found at the mid-spinal cord at the T8 level, with no evidence of vertebral bone destruction. CONCLUSIONS: To the best of our knowledge, there is only one previous report in the literature describing a case of a bullet nucleus lodged into the inferior epidural spinal canal without destruction of the vertebral bone. With the rise of violence worldwide the incidence of gunshot injuries continues to increase, and, thus, it is essential for radiologists to have a clear understanding of gunshot injuries and the findings on radiographic images.