Joseph Wilson Owen MD, Presenter: Nothing to Disclose

Kathryn Jane Fowler MD, Abstract Co-Author: Research support, Bracco Group

Nael El Said Saad MBBCh, Abstract Co-Author: Research Consultant, Veran Medical Technologies, Inc Proctor, Sirtex Medical Ltd

Increased splenic flow may be a compensatory mechanism to maintain portal flow in the face of increasing hepatic resistance/portal hypertension. Hypersplenism can be due to marrow disorders, resulting in increased splenic capacity and blood flow. These high flow states can exacerbate the complications of portal hypertension. Treatment of hypersplensim may reduce overflow phenomenon in patients at risk for variceal bleeding.

Associations Myelo/Lymphoproliferative Disorders Portal Hypertension (PHTN) Pathophysiology Hypertrophy Arterial Recruitment Splenic Outflow Sequelae Leuko/Thrombocytopenia Hemorrhage - Splenic/portal flow ratio may correlate with varical bleeding Post Transplant PHTN - Increased splenic flow persists, so PHTN persists despite normal hepatic resistance Treatments Partial/Complete Splenic Embolization Splenectomy TIPS/BRTO Case 1 17 y/o h/o liver transplant with post transplant PHTN Esophageal varices Biopsy- Noncirrhotic PHTN Elevated splenic flow Splenectomy vs splenic embolization Case 2 34 y/o with noncirrhotic PHTN and splenomegally Variceal hemorrhage PHTN treated with TIPS Recurent variceal bleeding Splenectomy with resolution of PHTN

http://abstract.rsna.org/uploads/2014/14001235/14001235_g7yl.pdf

Owen, J, Fowler, K, Saad, N, The Role of Hypersplenism in Complicated Portal Hypertension.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001235.html