Document Detail

Bleeding portal-hypertensive gastropathy managed successfully by partial splenic embolization.
MedLine Citation:
PMID:  12143250     Owner:  NLM     Status:  MEDLINE    
The use of partial splenic embolization to decrease portal pressure and reduce gastric bleeding from portal-hypertensive gastropathy, a complication of liver cirrhosis, is described. A 62-year-old man with hepatic cirrhosis secondary to hepatitis C and documented portal hypertension was admitted with hypersplenism and bleeding esophageal varices. Endoscopic ligation successfully controlled acute bleeding, but blood loss continued over the next 45 days. Bleeding secondary to portal-hypertensive gastropathy was diagnosed endoscopically. The patient's poor surgical status precluded a portosystemic shunt procedure, so partial splenic embolization was performed radiologically by the injection of Gelfoam squares. Splenic volume decreased 50% following partial embolization. Over 3 weeks, the hemoglobin concentration increased from 8.5 g/dL to 9.8 g/dL, and the platelet count increased from 41,000 to 90,000/microL. Repeat endoscopy found no gastric bleeding 18 days post-procedure. Partial splenic embolization is a radiologic procedure which can be performed safely in patients too ill to undergo portosystemic shunt. This report documents its successful use to manage hypersplenism and reduce portal pressure in a cirrhotic patient with portal-hypertensive gastropathy and hypersplenism.
Tetsuya Shimizu; Masahiko Onda; Takashi Tajiri; Hiroshi Yoshida; Yasuhiro Mamada; Nobuhiko Taniai; Takumi Aramaki; Tatsuo Kumazaki
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  49     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2002 Jul-Aug
Date Detail:
Created Date:  2002-07-29     Completed Date:  2003-02-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  947-9     Citation Subset:  IM    
First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
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MeSH Terms
Carcinoma, Hepatocellular / complications
Embolization, Therapeutic / methods*
Esophageal and Gastric Varices / radiography,  therapy*
Gastrointestinal Hemorrhage / radiography,  therapy*
Hepatitis C, Chronic / complications
Hypersplenism / radiography,  therapy*
Hypertension, Portal / complications*,  radiography,  therapy
Liver Cirrhosis / complications
Liver Neoplasms / complications
Middle Aged
Spleen / blood supply*
Tomography, X-Ray Computed
Treatment Outcome

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