Stepwise partial splenic embolization for portal hypertension based on a new concept: Splanchnic caput Medusae
| Autor: | Nobumasa Hamaguchi, Norihiro Hokimoto, Kazuhisa Onishi, Satoshi Ito, Koji Ueta, Sawaka Yukishige, Haruka Takasugi, Kai Mizobuchi, Hisashi Matsuoka, Niranjan Sharma, Nobuyuki Tanida, Fumio Chikamori, Hiromichi Yamai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty Portal venous pressure medicine.medical_treatment lcsh:R895-920 Liver fibrosis Spleen Case Report Gastroenterology 030218 nuclear medicine & medical imaging Retrograde obliteration 03 medical and health sciences 0302 clinical medicine Esophageal varices Internal medicine Sclerotherapy Medicine Radiology Nuclear Medicine and imaging Portal hypertension Partial splenic embolization business.industry medicine.disease Splanchnic caput Medusae medicine.anatomical_structure Endoscopic injection sclerotherapy with ligation medicine.symptom business Ligation Splanchnic 030217 neurology & neurosurgery Caput medusae |
| Zdroj: | Radiology Case Reports, Vol 16, Iss 3, Pp 564-570 (2021) Radiology Case Reports |
| ISSN: | 1930-0433 |
| Popis: | Management of splenomegaly with thrombocytopenia is important in the treatment of portal hypertension. We propose a new concept: "Splanchnic Caput Medusae" in which enlarged spleen is her face and portal collateral pathways are her snake hairs. We report 2 demonstrable cases who were treated based on this new concept. Case 1 with refractory esophageal varices and splenomegaly was treated by stepwise partial splenic embolization (PSE) and endoscopic injection sclerotherapy with ligation. Spleen/liver volume ratio changed from 0.33 to 0.10. Hepatic venous pressure gradient changed from 19 to 14 mmHg. Case 2 with mesenteric shunt and splenomegaly was treated by stepwise PSE and retrograde obliteration. Spleen/liver volume ratio changed from 0.70 to 0.05. Hepatic venous pressure gradient changed from 11 to 7 mmHg. In these 2 cases, 3D-CT reconstruction images after treatment revealed that spleen- portal system reversed almost to normal form. We conclude that splenomegaly and portal collateral pathways could be considered as "Splanchnic Caput Medusae" and have to be treated by stepwise PSE. |
| Databáze: | OpenAIRE |
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