title: Role of splenic artery partial embolization in a patient with portal hypertension and pancytopenia undergoing hysterectomy under anesthesia.
abstract: Management of a patient with portal hypertension and hypersplenism who is scheduled for elective surgery is a challenge for anesthesia providers. We report a case that was scheduled for elective surgery in which preoperative splenic artery embolization improved the hematologic parameters. A 32-year-old woman was scheduled for total abdominal hysterectomy for multiple fibroids and menorrhagia with pancytopenia. She also had diagnoses of chronic liver disease with cirrhotic changes, portal hypertension, and grade IV Manageesophageal varices with hepatosplenomegaly. In view of pancytopenia, splenic artery partial embolization was done preoperatively. Her hematologic parameters improved, and she underwent surgery under general anesthesia with intrathecal morphine analgesia, uneventfully. The condition of patients with portal hypertension with associated hypersplenism and pancytopenia who are scheduled for elective surgery can be optimized with preoperative partial splenic artery embolization.
authors.affiliation: Department of Anesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. drrgarg@hotmail.com
authors.forename: Ravindra
authors.initials: R
authors.lastname: Pandey
authors.forename: Rakesh
authors.initials: R
authors.lastname: Garg
authors.forename: Vanlal
authors.initials: V
authors.lastname: Darlong
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Punj
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000150:complications* / Q000628:therapy; D006975:Hypertension, Portal / Q000150:complications*; D007044:Hysterectomy; D007889:Leiomyoma / Q000601:surgery*; D009719:Nurse Anesthetists; D010198:Pancytopenia / Q000150:complications*; D011300:Preoperative Care; D013157:Splenic Artery