Nonsurgical splenectomy

Castańeda-Zúńiga, W R; Hammerschmidt, D. E.; Sanchez, R; Amplatz, K

doi:10.2214/ajr.129.5.805

Cited by 59 publications

(30 citation statements)

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“…While alternatives to total splenectomy for the treatment of hypersplenism, including partial splenectomy, percutaneous intraluminal occlusion of the splenic artery and embolic therapy, have been tried, the associated complications, including splenic abscess, splenic rupture, pneumonia, pleural effusion, septicemia, and pancreatitis, make them an unsuitable form of treatment in patients with SCD. [30][31][32] We found splenectomy to be a beneficial remedy in these patients. Not only did their transfusion requirements decrease markedly postoperatively, but it also eliminated the discomfort from the mechanical pressure of the enlarged spleen.…”

Section: Discussionmentioning

confidence: 84%

Splenectomy for Hematological Diseases: The Qatif Central Hospital Experience

et al. 1999

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Section: Discussionmentioning

confidence: 84%

Splenectomy for Hematological Diseases: The Qatif Central Hospital Experience

et al. 1999

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“…The patient responded well and no complications were reported at 5 mo follow-up. Despite Maddison's [6] early success, numerous complications of total splenic artery embolization were soon discovered [7] . Complications included splenic abscess, splenic rupture, pneumonia, septicemia, and death.…”

Section: Introductionmentioning

confidence: 99%

Partial splenic artery embolization in cirrhotic patients

Hadduck¹,

McWilliams²

2014

WJR

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Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including: decreased hematologic indices, portal hypertension and its associated sequela, and splenic artery steal syndrome. Following PSE patients demonstrate significant increases in platelets and leukocytes. Though progressive decline of hematologic indices occur following PSE, they remain improved as compared to pre-procedural values over long-term follow-up. PSE, however, is not without risk and complications of the procedure may occur. The most common complication of PSE is post-embolization syndrome, which involves a constellation of symptoms including fever, pain, and nausea/vomiting. The rate of complications has been shown to increase as the percent of total splenic volume embolized increases. The purpose of this review is to explore the current literature in regards to PSE in cirrhotic patients and to highlight their techniques, and statistically summarize their results and associated complications. Key words: Partial splenic embolization; Cirrhosis; Liver disease; Thrombocytopenia; Leukopenia Core tip: Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst cirrhotic patients that are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including: decreased hematologic indices, portal hypertension and its associated sequela, and splenic artery steal syndrome.Hadduck TA, McWilliams JP. Partial splenic artery embolization in cirrhotic patients. World J Radiol 2014; 6(5): 160-168 Available from:

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“…1 To avoid the increased susceptibility for bacterial infections and septicemia associated with splenectomy, 2,3 surgical as well as radiological methods for subtotal destruction of the splenic function have been proposed, 4-6 both used singularly 6,7 or in combination. 8,9 Retention of about one third of the normal splenic volume appears necessary to prevent an increased risk of septicemia. 10 Splenic embolization, partial or total, has been accompanied by complications, primarily splenic rupture and abscess formation.9,11 Some authors, however, describe only a low frequency of minor and moderately severe complications after partial splenic embolization.12-14…”

Section: Discussionmentioning

confidence: 99%

“…12,14,15 Some authors advocate that splenectomy should always follow a total or partial splenic embolization to lessen the risk of splenic rupture or abscess formation. 8,9,11 However, in the larger series of cases of partial splenic embolization without subsequent splenectomy there were only a few significant complications reported.…”

Section: Discussionmentioning

confidence: 99%