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ID 47084
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Title Alternative
Splenic artery syndrome after living donor liver transplantation with ligation of the splenic artery : A case report
Author
Satoh, Daisuke
Yagi, Takahito Kaken ID researchmap
Umeda, Yuzo
Yoshida, Ryuichi
Utsumi, Takashi
Fujiwara, Toshiyoshi ORCID Kaken ID
Abstract
After orthotopic liver transplantation, splenic artery syndrome (SAS), a phenomenon by which the main blood flow of the impaired hepatic artery is shifted to the splenic artery or gastroduodenal artery despite the absence of a structural lesion involving the anastomosis, has occasionally been observed. We report a 20-year-old women who developed SAS with pancytopenia and refractory ascites after living donor liver transplantation despite intraoperative ligation of the splenic artery as a prophylactic treatment for SAS. In this case SAS was diagnosed by digital subtraction angiography (DSA). A celiac trunk angiogram showed relative hypoperfusion of the hepatic artery together with augmentation of the blood flow toward the spleen with the unique collateral circulation through the left gastric artery, stomach and short gastric artery, and distal splenic artery. Embolization of one of the two left gastric arteries was performed. After embolization the hepatic artery perfusion showed significant improvement, but reduced again the next day. We ultimately conducted splenectomy. This case showed portal hyperperfusion and portal hypertension, consistent with previous reports that have described an association of SAS with portal hyperperfusion. After splenectomy, there was significant improvement in the hepatic artery perfusion, ascites disappeared promptly, and pancytopenia was significantly improved.
Keywords
脾動脈症候群 (splenic artery syndrome)
脾動脈結紮 (ligation of the splenic artery)
生体肝移植 (living donor liver transplantation)
Note
症例報告 (Case Report)
Published Date
2011-12-01
Publication Title
岡山医学会雑誌
Publication Title Alternative
Journal of Okayama Medical Association
Volume
volume123
Issue
issue3
Publisher
岡山医学会
Publisher Alternative
Okayama Medical Association
Start Page
207
End Page
211
ISSN
0030-1558
NCID
AN00032489
Content Type
Journal Article
Related Url
http://www.okayama-u.ac.jp/user/oma/
language
日本語
Copyright Holders
Copyright (c) 2011 岡山医学会
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publisher
Refereed
True
DOI
Eprints Journal Name
joma