Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 3;12(7):2662.
doi: 10.3390/jcm12072662.

The Impact of Partial Splenic Embolization on Portal Hypertensive Gastropathy in Cirrhotic Patients with Portal Hypertension

Michio Saeki  1 , Hironao Okubo  1   2 , Yusuke Takasaki  1 , Eisuke Nakadera  1 , Yuka Fukuo  1 , Hiroo Fukada  2 , Yuta Hotchi  3 , Hitoshi Maruyama  2 , Shigehiro Kokubu  1   4 , Shuichiro Shiina  2 , Akihito Nagahara  2 , Kenichi Ikejima  2
Affiliations

The Impact of Partial Splenic Embolization on Portal Hypertensive Gastropathy in Cirrhotic Patients with Portal Hypertension

Michio Saeki et al. J Clin Med. .

Abstract

This study investigated the impact of partial splenic embolization (PSE) on portal hypertensive gastropathy (PHG). We retrospectively analyzed endoscopic findings and the portal venous system of 31 cirrhotic patients with PHG. The improved group was defined as the amelioration of PHG findings using the McCormack classification. Child-Pugh scores of the improved group (18 of 31 patients) were significantly lower compared with those of the non-improved group (p = 0.018). The changes in the diameters of the portal trunk and those of the spleno-portal junction and spleen hilum in the splenic vein of the improved group were significantly larger than those of the non-improved group (p = 0.007, p = 0.025, and p = 0.003, respectively). The changes in the diameters of the portal vein and splenic hilum of the splenic vein showed significant correlations with Child-Pugh score (r = 0.386, p = 0.039; r = 0.510, p = 0.004). In a multivariate analysis of baseline factors related to the improved group, Child-Pugh grade A was significantly associated with the improvement of PHG (odds ratio 6.875, p = 0.033). PSE could be useful for PHG, especially in patients with Child-Pugh grade A, at least in the short term.

Keywords: hypertensive gastropathy; liver impairment; portal hemodynamics; portal hypertension; splenic embolization.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design and inclusion and exclusion criteria for partial spleen embolization.
Figure 2
Figure 2
McCormack classification of endoscopy before and after partial spleen embolization.
Figure 3
Figure 3
Radiological changes before and after partial spleen embolization.
Figure 4
Figure 4
The relationship between changes in portal hemodynamics after partial splenic embolization and Child–Pugh score.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. McCormack T.T., Sims J., Eyre-Brook I., Kennedy H., Goepel J., Johnson A.G., Triger D.R. Gastric lesions in portal hypertension: Inflammatory gastritis or congestive gastropathy? Gut. 1985;26:1226–1232. doi: 10.1136/gut.26.11.1226. - DOI - PMC - PubMed
    1. Casadevall M., Panés J., Piqué J.M., Marroni N., Bosch J., Whittle B.J. Involvement of nitric oxide and prostaglandins in gastric mucosal hyperemia of portal-hypertensive anesthetized rats. Hepatology. 1993;18:628–634. doi: 10.1002/hep.1840180323. - DOI - PubMed
    1. Simbrunner B., Beer A., Wöran K., Schmitz F., Primas C., Wewalka M., Pinter M., Dolak W., Scheiner B., Puespoek A., et al. Portal hypertensive gastropathy is associated with iron deficiency anemia. Wien Klin. Wochenschr. 2020;132:1–11. doi: 10.1007/s00508-019-01593-w. - DOI - PMC - PubMed
    1. Buechter M., Kahraman A., Manka P., Gerken G., Dechêne A., Canbay A., Wetter A., Umutlu L., Theysohn J.M. Partial spleen embolization reduces the risk of portal hypertension-induced upper gastrointestinal bleeding in patients not eligible for TIPS implantation. PLoS ONE. 2017;12:e0177401. doi: 10.1371/journal.pone.0177401. - DOI - PMC - PubMed
    1. de Franchis R., Primignani M. Natural history of portal hypertension in patients with cirrhosis. Clin. Liver Dis. 2001;5:645–663. doi: 10.1016/S1089-3261(05)70186-0. - DOI - PubMed

LinkOut - more resources