Severe thrombocytopenia due to hypersplenism successfully treated with partial splenic embolization in preoperative management.
Hypersplenism is a known complication of portal hypertension secondary to cirrhosis of the liver. Although thrombocytopenia secondary to hypersplenism does not cause clinically significant hemostatic defect, it may need to be addressed in selective circumstances, such as preoperative preparation for a surgery. This report describes a 30-year-old male with a history of cirrhosis of the liver and hypersplenism who had a recurrence of craniopharyngioma. A platelet count of 40 x 10(9)/L limited his treatment options. A stereotactic injection of radioactive P32 into the tumor was planned but was thought not to be feasible because of the thrombocytopenia. The thrombocytopenia responded favorably to partial splenic embolization, and the patient underwent successful stereotactic injection of radioactive P32 into the tumor.
Pinto
Amar G
AG
Division of Gastroenterology/Hepatology and Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Namyslowski
Jan
J
Pandya
Prashant
P
D000328:Adult; D003397:Craniopharyngioma / Q000532:radiotherapy; D004621:Embolization, Therapeutic; D006801:Humans; D006971:Hypersplenism / Q000150:complications* / Q000628:therapy*; D006975:Hypertension, Portal / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D010911:Pituitary Neoplasms / Q000532:radiotherapy; D013921:Thrombocytopenia / Q000209:etiology* / Q000628:therapy*