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We report a rare case of haemolytic anaemia where splenectomy was carried out following trauma to a massively enlarged spleen and was followed by extreme sustained thrombocytosis associated with extensive portal, splenic and mesenteric vein thrombosis despite standard antithrombotic prophylaxis.<\/jats:p>","DOI":"10.1136\/bcr-2013-201061","type":"journal-article","created":{"date-parts":[[2013,11,28]],"date-time":"2013-11-28T05:20:48Z","timestamp":1385616048000},"page":"bcr2013201061","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Splenectomy complicated by sustained extreme thrombocytosis and extensive portosplenomesenteric vein thrombosis in pyrimidine 5\u2032-nucleotidase deficiency"],"prefix":"10.1136","volume":"2013","author":[{"given":"Hassan A","family":"Al-Jafar","sequence":"first","affiliation":[{"name":"Department of Haematology, Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Taqi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Patrick","family":"Madda","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thamer A","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Radiology, Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,11,28]]},"reference":[{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12682"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.2","doi-asserted-by":"publisher","DOI":"10.4076\/1757-1626-2-6450"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.3","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/102490790301000309","article-title":"Delayed rupture of occult splenic injury: a case report","volume":"10","author":"Chan","year":"2003","journal-title":"Hong Kong J Emerg Med"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1996.tb00791.x"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.5","first-page":"536062","article-title":"Thrombocytosis: diagnostic evaluation, thrombotic risk stratification, and risk-based management strategies","volume":"2011","author":"Jonathan","year":"2011","journal-title":"Thrombosis"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.6","first-page":"352","article-title":"Incidence of portal vein thrombosis after laparoscopic splenectomy","volume":"48","author":"Harris","year":"2005","journal-title":"Can J Surg"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.7","unstructured":"Hoffbrandetal AV . Postgraduate haematology. 6th edn. Wiley Blacwell, chapter 9, disorder of red cell metabolism 152\u20133."},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04532.x"},{"key":"2025082804091330000_2013.nov28_1.bcr2013201061.9","doi-asserted-by":"crossref","unstructured":"Al-Jafar HA Layton DM Robertson L . Diagnosis of pyrimidine 5\u2019-nucleotidase deficiency suspected from a blood film. Am J Hematol. 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