DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173598

Hypersplenism in a young girl: managed non-surgically

Tanvi Batra, Shipra Gulati, Vijayashree S. Gokhale, Arjun Lal Kakrani

Abstract


A 16-years-old female, non-alcoholic, presented with pain in left hypochondrium and distention of abdomen. Her USG Abdomen, portal vein doppler and CT abdomen revealed chronic thrombosis of intrahepatic portion of portal vein with multiple collaterals and gross splenomegaly suggestive of portal hypertension. Trans jugular liver biopsy showed no regeneration or fibrosis of liver. Endoscopy showed grade III oesophageal and gastric varices. Splenic artery embolisation was done for hypersplenism. Post procedure CT abdomen revealed large areas of splenic infarction-sequelae of splenic artery embolization. 


Keywords


Hypersplenism, Portal hypertension, Splenic artery embolization, Trans jugular liver biopsy

Full Text:

PDF

References


Connell NT, Shurin SB, Schiffman FJ. The spleen and its disorders. In: Hoffman R, Benz EJ, Silberstein LE, Heslop HE, Weitz JI, Anastasi J, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2013:162.

Dameshek W. Hypersplenism. Bull NY Acad Med. 1955;31:113-36.

Lv Y, Lau WY, Li Y, Deng J, Han X, Gong X, et al. Hypersplenism: history and current status. Experimental Therapeutic Med. 2016;12(4):2377-82.

Kenawi MM, El-Ghamrawi KA, Mohammad AA, Kenawi A, El-Sadek AZ. Splenic irradiation for the treatment of hypersplenism from congestive splenomegaly. Br J Surg. 1997;84:860-1.

Spigos DG, Jonasson O, Mozes M, Capek V. Partial splenic embolization in the treatment of hypersplenism. AJR Am J Roentgenol. 1979;132:777-82.

Chernykh ER, Starostina NM, Paltsev AI, Leplina OY, Shevela EY, Shipunov MV, et al. Autologous bone marrow cells in the treatment of cirrhosis of the liver. Bull Exp Biol Med. 2007;144:640-5.

He XH, Li WT, Peng WJ, Li GD, Wang SP, Xu LC. Total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism. World J Gastroenterol. 2011;17:2953-7.

Krishnan SK, Hill A, Hillmen P, Arnold LM, Brooksbank GL, Wood A, et al. Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal haemoglobinuria on eculizumab. Int J Hematol. 2013;98:716-8.

N'Kontchou G, Seror O, Bourcier V, Mohand D, Ajavon Y, Castera L, et al. Partial splenic embolization in patients with cirrhosis: efficacy, tolerance and long-term outcome in 32 patients. Eur J Gastroenterol Hepatol. 2005;17:179-84.

Kim H, Suh KS, Jeon YM, Park MS, Choi Y, Mori S, et al. Partial splenic artery embolization for thrombocytopenia and uncontrolled massive ascites after liver transplantation. Transplant Proc. 2012;44:755-6.

Smith M, Ray CE. Splenic artery embolization as an adjunctive procedure for portal hypertension. Seminars Interventional Radiol. 2012;29(2):135-9.

Gaba RC, Katz JR, Parvinian A, Reich S, Omene BO, Yap FY, et al. Splenic artery embolization: a single center experience on the safety, efficacy, and clinical outcomes. Diagn Interv Radiol. 2013;19:49-55.

Wang Q, Xiong B, Zheng C, Liang M, Han P. Splenic arterial embolization in the treatment of severe portal hypertension due to pancreatic diseases: the primary experience in 14 patients. Cardiovasc Interventional Radiol. 2016;39:353-8.