Successful splenic artery embolization in a patient with Behçet’s syndrome-associated splenic rupture:A case report

BACKGROUND Splenic rupture associated with Behçet’s syndrome(BS)is extremely rare,and there is no consensus on its management.In this case report,a patient with BSassociated splenic rupture was successfully treated with splenic artery embolization(SAE)and had a good prognosis after the intervention.CASE SUMMARY The patient was admitted for pain in the left upper abdominal quadrant.He was diagnosed with splenic rupture.Multiple oral and genital aphthous ulcers were observed,and acne scars were found on his back.He had a 2-year history of BS diagnosis,with symptoms of oral and genital ulcers.At that time,he was treated with oral corticosteroids for 1 month,but the symptoms did not alleviate.He underwent SAE to treat the rupture.On the first day after SAE,the patient reported a complete resolution of abdominal pain and was discharged 5 d later.Three months after the intervention,a computed tomography examination showed that the splenic hematoma had formed a stable cystic effusion,suggesting a good prognosis.CONCLUSION SAE might be a good choice for BS-associated splenic rupture based on good surgical practice and material selection.

Total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism

AIM:To study the safety and feasibility of total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.METHODS:Fifteen consecutive patients with hypersplenism due to cirrhosis were enrolled in this study from January 2006 to June 2010.All patients underwent total embolization of the main splenic artery.Clinical symptoms,white blood cell(WBC) and platelet(PLT) counts,splenic volume,and complications of the patients were recorded.The patients were followed up for 1 and 6 mo,and 1,2,3 years,respectively,after operation.RESULTS:Total embolization of the main splenic artery was technically successful in all patients.Minor complications occurred in 13 patients after the procedure,but no major complications were found.The WBC andPLT counts were significantly higher and the residual splenic volume was significantly lower 1 and 6 mo,and 1,2,3 years after the procedure than before the procedure(P < 0.01).Moreover,the residual splenic volume increased very slowly with the time after embolization.All patients were alive during the follow-up period.CONCLUSION:Total embolization of the main splenic artery is a safe and feasible procedure and may serve as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.

Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization:a case report and literature review

Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography(CT)scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.