What is the treatment of choice for varices associated with splenic vein thrombosis?

The treatment of choice for varices associated with splenic vein thrombosis is splenectomy. When there is a thrombosis of the splenic vein, it can lead to increased pressure in the portal circulation, contributing to the formation of varices, particularly in the esophagus and stomach.

Removing the spleen not only resolves the underlying issue of splenic vein obstruction but also decreases portal hypertension by addressing the source of venous congestion. Splenectomy can significantly reduce the risk of variceal bleeding by alleviating portal pressure, as well as decreasing the splenic mass effect that may further contribute to venous complications.

Other potential treatments, such as endoscopic interventions (band ligation and sclerotherapy) aimed at managing the varices directly, typically do not address the underlying cause of the portal hypertension related to splenic vein thrombosis. Moreover, spleen transplantation is not a common approach for treating varices linked to splenic vein issues, as it is more complex and less indicated in this specific scenario. Thus, splenectomy is the most effective and direct way to manage varices caused by this condition.