Open AccessPartial Splenic Embolization for Hypersplenism Associated with Steatohepatitis in a Hemodialysis Patient
Author(s) -
Kamel El-Reshaid,
Fahad Alabdulghani,
Shaikha Al-Bader
Publication year - 2021
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.318535
Subject(s) - medicine , splenectomy , splenic infarction , cirrhosis , gastroenterology , hemodialysis , cytopenia , portal hypertension , bone marrow , pathology , spleen
Hypersplenism (HS) is a disorder characterized by a triad of splenomegaly, peripheral cytopenia due to premature destruction of blood cells and normocellular bone marrow. Its etiology is diverse and includes (a) primary autoimmune cytopenias, (b) secondary to congestion due to portal hypertension in cirrhosis and, other causes such asperiportal fibrosis, infections, autoimmune diseases, lymphoproliferative disorders, infiltrative diseases and hemolytic anemias. The latter diseases are common in patients with end-stage kidney disease. In severe cases, co-existence of multiple co-morbid conditions, coagulopathy of uremia and dialysis-anticoagulation, and their immunosuppressive state render surgical splenectomy at highrisk. Mid-segment partial splenic infarction and with an aim at 50%-70% splenic volume loss was shown to be a less invasive therapy for HS. In our case report, we describe its first successful trial in a hemodialysis patient with severe HS due to cirrhosis.