Ischemic therapy in thrombocytopenia from hypersplenism
C. L. Witte, T. W. Ovitt, D. B. Van Wyck, M. H. Witte, R. E. O'Mara and J. M. Woolfenden
Percutaneous transfemoral arterial balloon occlusion or gelatin sponge
embolization of the splenic artery or both were carried out in three
high-risk patients with hepatic cirrhosis to reduce splenic hyperfunction
and improve severe thrombocytopenia. Although this maneuver raised
peripheral platelet counts in each patient, in one patient left upper
quadrant pain with splinting of the lower chest cage led to hypostatic
lower lobe pneumonia, while in another septic splentitis with gas-forming
organisms necessitated splecectomy. Transfemoral occlusion of the splenic
artery, although an effective, noninvasive approach to control splenic
hyperfunction, has at the same time potential dangers that should be viewed
with extreme caution in therapeutic application.
