[Partial splenic embolization as a preoperative treatment for refractory idiopathic thrombocytopenic purpura].
A 53-year-old woman presented with idiopathic thrombocytopenic purpura (ITP) that was refractory to corticosteroid therapy. Her bleeding had worsened gradually due to prolonged thrombocytopenia, but her low platelet count after high-dose intravenous gamma globulin therapy contraindicated a splenectomy. We therefore decided to perform a partial splenic embolization (PSE). The patient's platelet count increased gradually thereafter, allowing us to safely perform a splenectomy. We concluded that PSE is a useful preoperative procedure, especially for patients with ITP that is refractory to high-dose intravenous gamma-globulin therapy. Moreover, it is possible to predict the effects of a splenectomy preoperatively if the PSE procedure is used.
Department of Internal Medicine, National Kokura Hospital.
Y
Y
Sadamoto
Y
Y
Abe
K
K
Kato
J
J
Nishimura
D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery* / Q000628:therapy; D013156:Splenectomy; D013157:Splenic Artery