She was also thrombocytopenic from platelet sequestration and destruction in the enlarged spleen. On the basis of venous collateralization, a diagnosis of splenic vein thrombosis was made. Because of a pre-op platelet count of 30,000, one quad pack of platelets was administered prior to the start of the operation. A minimal platelet count of 50,000 is necessary to safely proceed with surgery.
Massive enlargement makes exposure of the splenic ligaments and vessels much more difficult.
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