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Splanchnic Thrombosis — SCE Medical Oncology MCQ

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ModerateGI CancersSplanchnic ThrombosisSCE Medical Oncology

A 65-year-old man with pancreatic cancer develops a new splenic vein thrombosis on CT during chemotherapy. He is asymptomatic. What is the management?

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Correct answer: B — Therapeutic anticoagulation for cancer-associated splenic-vein thrombosis

Splanchnic vein thrombosis (portal, mesenteric, splenic) occurs in approximately 5-10% of pancreatic cancer patients. Current ISTH guidelines recommend anticoagulation for cancer-associated splanchnic thrombosis, particularly with: symptoms, risk of extension, or active cancer. LMWH is preferred due to lower GI bleeding risk than DOACs in splanchnic thrombosis. Duration is typically ≥6 months and while cancer is active. Asymptomatic incidental splanchnic thrombosis in cancer also generally warrants treatment.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer