Delayed Splenic Rupture After a Percutaneous Transsplenic Approach to Treat Portal Vein Occlusion
- Authors
- Hwang, Jung Han; Kim, Jeong Ho; Park, Suyoung; Lee, Ki Hyun
- Issue Date
- Aug-2021
- Publisher
- SAGE Publications Inc.
- Keywords
- embolization; portal vein; spleen; splenic vein; transhepatic; transsplenic
- Citation
- Vascular and Endovascular Surgery, v.55, no.6, pp.623 - 626
- Journal Title
- Vascular and Endovascular Surgery
- Volume
- 55
- Number
- 6
- Start Page
- 623
- End Page
- 626
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81657
- DOI
- 10.1177/1538574421992932
- ISSN
- 1538-5744
- Abstract
- Purpose: To report a case of delayed splenic rupture after percutaneous transsplenic portal vein stent deployment. Case Report: A 72-year-old male patient presented at a medical center with abdominal pain and reduced liver function according to laboratory tests. Due to a history of right hemihepatectomy and left portal vein occlusion, the percutaneous transhepatic approach was considered inappropriate. Instead, percutaneous transsplenic access was selected as a suitable procedure for portal vein catheterization. Eight days following the procedure, the patient developed abdominal pain, and a computed tomography scan showed a small splenic pseudoaneurysm that was underappreciated at the time. Patient suffered acute splenic rupture 32 days post-procedure. Subsequent embolization was performed, achieving complete hemostasis. Conclusion: The transsplenic approach should be considered when the transhepatic or transjugular approach is unfeasible or difficult to implement. A careful plugging of the puncture tract is necessary to prevent or minimize hemorrhage from the splenic access tract. In addition, careful serial follow-up computed tomography should be used to evaluate the splenic puncture tract. © The Author(s) 2021.
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