Open AccessImproved safety of splenoportography by plugging of the needle tract
Author(s) -
Peter Probst,
J P Rysavy,
K Amplatz
Publication year - 1978
Publication title -
american journal of roentgenology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.294
H-Index - 196
eISSN - 1546-3141
pISSN - 0361-803X
DOI - 10.2214/ajr.131.3.445
Subject(s) - medicine , surgery , portal hypertension , radiology , cirrhosis , gastroenterology
Splenoportography, a useful preoperative diagnostic procedure in patients with portal hypertension, has been largely discontinued because of the risk of hemorrhage. We have used both Ivalon and Gelfoam in particle and plug form to plug the needle tract after splenoportography. Initial studies were conducted on six dogs. Plugging of the needle tract by injection of suspensions of small Gelfoam or Ivalon particles resulted in intravasation of these particles into the splenic vein. This was demonstrated by radioactive tagging of particles and the direct collection of splenic blood during the intrasplenic injection. Plugging of the splenic needle tract with compressed Gelfoam caused immediate, complete cessation of bleeding in fully heparinized animals. Because of these experimental results, five humans with decreased platelet counts and severe portal hypertension underwent successful splenoportography without significant hemorrhage. At surgery, successful plugging of the needle tract by Gelfoam was confirmed.