A case of liver cirrhosis with hypersplenism undertaken transcatheter splenic arterial embolization (TSAE)

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A 42-year-old male with liver cirrhosis was managed by TSAE treatment prior to endoscopic injection sclerotherapy (ST) for esophageal varices. Peripheral platelet count was 2.7×104/mm3 by hematological study on admission. Therefore, TSAE treatment was performed using particles of Gelfoam soluted with antibiotics and contrast medium. Platelet count increased to 11.3×104/mm3 at one and half months after the procedure, and thus following ST was possible to be performed during his hospitalization. A repeated angiography performed after three and half months showed a decrease of the diameter of the splenic artery with an increased diameter of the hepatic artery. Additionally, the peripheral branches of the hepatic artery were opacified more clearly. Laboratory data, including liver function tests, prothrombin time, hepaplastin time and ICGR15, were also improved remarkably. It is suggested that the changes of the hemodynamic state after TSAE treatment may play a role in clinical improvement of this patients.
社団法人日本肝臓学会の論文