Efficacy of partial splenic embolisation in the management of hypersplenism

Objective: To assess the efficacy of partial splenic embolisation in the management of hypersplenism Material and Method: Eleven partial splenic embolisations were performed in nine children suffering from portal hypertension, aged 10 to 15 yrs (mean 12.5 years). All patients had splenomegaly with thrombocytopenia (platelet count less than 60x10, 9/ lit) and leucopenia at the time of the procedure. Portal hypertension was investigated in all patients with endoscopy, liver biopsy & abdominal sonography. Particles of polyvinyl alcohol were used to achieve embolisation of at least 75 percent of the splenic artery thereby causing embolisation of the peripheral splenic branches. Post embolisation arteriogram and ct were obtained to document the extent of devascularisation. Results: Peripheral count had improved significantly after partial splenic embolisation (PSE) and platelet count of more than 450 x 10 9 lit was present in nine of the eleven patients by the end of the seventh day. Leucocyte count rose significantly by day one and seven after PSE compared with counts before the procedure. Reduction in size of the spleen was noticed in all patients. Six out of eight patients showed considerable reduction in size of the oesophageal and gastric varices. All patients had a moderate rise in temperature up to 38.5 degree C along with pain in the left hypochondrium. Segmental atelectasis was seen in three patients. Conclusion: Partial splenic artery embolisation is an effective procedure for the control of Hypersplenism.