Therapeutic arterial embolisation of the spleen: a new cause of free intraperitoneal gas.
Case histories of two patients are presented in whom splenectomy was required for haematological disorders, but because surgery was contraindicated had therapeutic arterial embolisation of the spleen performed as an initial alternative. A significant improvement in the haematological state was achieved in both cases but one of the patients required drainage of a splenic abscess three months later. In both patients the embolisation caused the early appearances of extravascular gas in the spleen and in one patient a pneumoperitoneum also occurred. The possible aetiological factors involved in this phenomenon are discussed, together with the potential role of splenic embolisation. It is concluded that therapeutic embolisation may be a useful alternative to splenectomy in selected poor-risk patients, but carries a significant risk of inducing a splenic abscess. Intrasplenic or intraperitoneal gas may appear as an apparently benign incidental finding in the early post-embolisation period.
D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D005740:Gases; D006801:Humans; D009503:Neutropenia / Q000628:therapy; D010529:Peritoneal Cavity; D013154:Spleen / Q000503:physiopathology; D013157:Splenic Artery
D005740:Gases