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"Introduction: Portal hypertension may cause gastrointestinal complications; one of the most serious is a ruptured esophageal varices. Portal hypertension is also the main cause of hypersplenism, which in turn could lead to pancytopenia. Despite adequate therapy, some cases of hypersplenism could not be resolved. Partial splenic embolization (PSE) is an effective alternative method to treat this condition. Method: We reported two cases of hypersplenism treated with PSE. The first case was a 10- year-old girl with pancytopenia and a history of recurrent esophageal ligation. The second case was a 32-year-old man with recurrent episodes of hematemesis for two years before admission. Results: After the PSE procedure, the first patient’s white blood cell and platelet doubled in one month after procedure and stable at follow-up three months later, with no complaint of hematemesis. The second patient’s platelet doubled five days after the procedure. The first patient developed a complication of a splenic abscess, but after antibiotic administration and pus drainage, the condition was resolved. Conclusion: PSE is an effective method to treat hypersplenism secondary to the hypertensive portal. Treatment goals successfully achieved include improvement in blood count and control of bleeding. There are risks following PSE, but with adequate treatment, it can be overcome. Keywords: hypersplenism, partial splenic embolization, portal hypertension, pancytopenia"

"Agenesis vena porta adalah kelainan yang jarang ditemukan dimana aliran darah vena dari limpa dan usus tidak melalui hepar tetapi mengalir ke aliran sistemik melalui berbagai pintasan. Dilaporkan satu kasus pasien wanita berusia 32 tahun dengan kelainan ini dimana pasien mengalami hematemesis dan melena berulang dan didapati adanya splenomegali dan hipersplenisme. Pada angiografi tidak ditemukan adanya vena porta. Dilakukan tindakan splenektomi untuk menurunkan tekanan pada vena-vena sekitar gaster dan mengkoreksi hipersplenisme. Enam bulan pasca operasi dilakukan endoskopi dengan hasil varises pada esofagus sudah menghilang sedangkan varises pada gaster sudah mengecil. (Med J Indones 2004; 14: 122-7)

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Congenital Absence of the Portal Vein (CAPV) is a rare anomaly in which the intestinal and splenic venous drainage bypasses the liver and drains into the systemic veins through various venous shunts. We present a case of a 32-year-old woman with this malformation, the patient experienced hematemesis and melena repetitively and had splenomegaly and hypersplenism. The angiography demonstrated absence of portal vein. Splenectomy was performed to reduce the pressure of the veins around stomach and to correct the hypersplenism. In endoscopy examination six months after surgery, the esophageal varices had disappear and the size of gastric varices had decrease. (Med J Indones 2004; 14: 122-7)"