Haematology

Treatment

• He has localised pancreatic cancer and undergoes a Whipple's resection. During the surgery the spleen is damaged and intra-operative splenectomy is required.
• Over the next 10 days his platelet count rises to 1200x10⁹ / L

Is this more likely to be Primary or Secondary (reactive) thrombocytosis?

Primary
Secondary

Please answer each row

Post-Splenectomy Thrombocytosis

After any major surgery the platelet count typically rises to a peak between 10 - 14 days post-operatively. Standard thromboprophylaxis is indicated with no need for extra anti-platelet therapy or other specific treatment. A mild thrombocytosis (Plt 400 - 700x10⁹ / L) usually persists lifelong post-splenectomy and again does not require investigation or treatment. Other post-splenectomy changes include mild lymphocytosis, monocytosis, eosinophilia and the presence of Howell-Jolly bodies and target cells on the blood film.