Image-guided Percutaneous Splenic Interventions

Abstract

In the spleen, image-guided interventional procedures such as biopsy and catheter drainage have not been widely performed because of the perceived increased risk of complications. The ability of image-guided biopsy to allow tissue diagnosis of a focal splenic mass without the need for splenectomy is the driving force behind use of this procedure in oncology patients. The literature on image-guided splenic biopsy suggests that the highest biopsy yield is achieved with core biopsy and the lowest complication rate is achieved with fine-needle aspiration. Image-guided catheter drainage is an effective alternative to splenectomy for management of infected splenic collections. In clinical practice, image-guided splenic biopsy, fluid aspiration, and catheter drainage have high success rates. Image-guided alcohol ablation is effective in treatment of splenic cysts. The literature on splenic radiofrequency ablation (RFA) is sparse; therefore, further studies are needed to determine the role of RFA in management of splenic neoplasms and hypersplenism. Image-guided percutaneous thrombin injection can be used to treat splenic artery pseudoaneurysms. Awareness of the correct interventional techniques and their limitations is important for safe performance of image-guided percutaneous splenic interventions.

Ultrasound-guided percutaneous splenic biopsy using an 18-G core biopsy needle: our experience with 52 cases

“…Splenic biopsy is reserved for those with unexplained abnormality or in the presence of a known underlying malignancy, usually lymphoma, where histology is required for staging. 1 In such cases, biopsy of the spleen is considered when there is no other safer accessible site to obtain tissue for histology. 2 A commonly held view amongst clinicians is that there is significant morbidity associated with splenic biopsy.…”

Isolated splenic tuberculosis with subsequent paradoxical deterioration: a case report

“…CNB has a high diagnostic yield in splenic pathology [25] and has demonstrated superior diagnostic accuracy to FNAC in characterising splenic lesions [26, 27]. Tubercular infection is histologically confirmed by presence of typical caseation with granuloma of Langhan’s giant cells and epitheloid cells.…”

Aseptic Splenic Abscess as Precursory Extraintestinal Manifestation of Inflammatory Bowel Disease

“…Two groups from Japan and one group from Taiwan noted that gram-negative bacillus accounted for 46.7%–60% of their cases [6, 23]. Predisposing factors, such as diabetes mellitus, malignancies, immunosuppressive medications, or immunodeficiency disorders, often play a role in the development of splenic abscess and should be considered when a splenic abscess is found [8, 21, 22, 24–26]. …”