Partial embolization as re-treatment of hypersplenism after unsuccessful splenic artery ligation

doi:10.3748/wjg.v21.i4.1365

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Jan 28, 2015; 21(4): 1365-1370
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1365

Partial embolization as re-treatment of hypersplenism after unsuccessful splenic artery ligation

Zheng-Ju Xu, Lian-Qiu Zheng, Xing-Nan Pan

Zheng-Ju Xu, Lian-Qiu Zheng, Xing-Nan Pan, Clinical Liver Center, 180^th Hospital of the People’s Liberation Army, Quanzhou 362000, Fujian Province, China

Author contributions: Xu ZJ conceived and coordinated the study, and participated in data collection and manuscript writing; Pan XN participated in the study design, data collection, and manuscript writing; Zheng LQ participated in data collection and manuscript writing.

Correspondence to: Zheng-Ju Xu, Associate Chief Physician, Clinical Liver Center, 180^th Hospital of the People’s Liberation Army, No. 180, Huayuan Road, Fengze District, Quanzhou 362000, Fujian Province, China. h180@163.com

Telephone: +86-595-28919590 Fax: +86-595-28919100

Received: June 13, 2014
Peer-review started: June 13, 2014
First decision: July 21, 2014
Revised: August 3, 2014
Accepted: September 12, 2014
Article in press: September 16, 2014
Published online: January 28, 2015
Processing time: 228 Days and 14.3 Hours

Core Tip

Core tip: Ligation of splenic artery (LSA) is used for the treatment of hypersplenism due to liver cirrhosis. However, hypersplenism is not always improved following LSA. We report a case of cirrhosis and hypersplenism which underwent LSA treatment, but failed to respond as manifested by persistent severe leukocytopenia and thrombocytopenia. Celiac computed tomography arteriogram and digital subtraction angiography revealed two compensatory arteries supplying the spleen. Partial splenic embolization (PSE) was performed through those arteries resulting in increased leukocyte and thrombocyte counts that remained within the normal range. PSE is an effective therapeutic modality for the retreatment of hypersplenism when other modalities have failed.