Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2015; 21(20): 6391-6397
Published online May 28, 2015. doi: 10.3748/wjg.v21.i20.6391
Radiofrequency ablation for treatment of hypersplenism: A feasible therapeutic option
Guilherme Lopes P Martins, Joao Paulo G Bernardes, Marcello S Rovella, Raphael G Andrade, Publio Cesar C Viana, Paulo Herman, Giovanni Guido Cerri, Marcos Roberto Menezes
Guilherme Lopes P Martins, Joao Paulo G Bernardes, Marcello S Rovella, Raphael G Andrade, Publio Cesar C Viana, Marcos Roberto Menezes, Radiology and Image-Guided Intervention Service, Instituto do Cancer do Estado de Sao Paulo, University of São Paulo, São Paulo 01415-000, Brazil
Paulo Herman, Department of Gastroenterology, University of São Paulo, São Paulo 01246-903, Brazil
Giovanni Guido Cerri, Instituto de Radiologia do Hospital das Clínicas da FMUSP, São Paulo 05403-900, Brazil
Marcos Roberto Menezes, Instituto de Radiologia do Hospital das Clínicas da FMUSP, São Paulo 05403-900, Brazil
Author contributions: Martins GLP, Herman P and Menezes MR designed the report; Martins GLP, Bernardes JPG, Rovella MR and Andrade RG collected the patient’s clinical data; Martins GLP, Viana PCC and Menezes MR analyzed the data and wrote the paper; Cerri GG and Menezes MR revised the paper.
Supported by Instituto do Cancer do Estado de Sao Paulo, University of São Paulo Medical School, Sao Paulo, SP, Brazil.
Ethics approval: The Human Research Ethical Review Committee at Faculdade de Medicina da Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo had evaluated the research proposal/study presented by Marcos Roberto de Menezes and colleagues.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marcos Roberto Menezes, MD, Director of Radiology and Image-Guided Intervention Service, Instituto do Cancer do Estado de Sao Paulo, University of São Paulo, Av. Doutor Arnaldo 251 1º andar, Sao Paulo 01415-000, Brazil. marcos.menezes@hc.fm.usp.br
Telephone: +55-11-38932000 Fax: +55-11-38932777
Received: October 6, 2014
Peer-review started: October 7, 2014
First decision: October 29, 2014
Revised: December 6, 2014
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: May 28, 2015
Processing time: 235 Days and 15.9 Hours
Abstract

We present a case of a patient with hypersplenism secondary to portal hypertension due to hepato-splenic schistosomiasis, which was accompanied by severe and refractory thrombocytopenia. We performed spleen ablation and measured the total spleen and ablated volumes with contrast-enhanced computed tomography and volumetry. No major complications occurred, thrombocytopenia was resolved, and platelet levels remained stable, which allowed for early treatment of the patient’s underlying disease. Previous work has shown that splenic radiofrequency ablation is an attractive alternative treatment for hypersplenism induced by liver cirrhosis. We aimed to contribute to the currently sparse literature evaluating the role of radiofrequency ablation (RFA) in the management of hypersplenism. We conclude that splenic RFA appears to be a viable and promising option for the treatment of hypersplenism.

Keywords: Portal hypertension; Thrombocytopenia; Hypersplenism; Percutaneous radiofrequency ablation; Splenic ablation

Core tip: The role of splenic radiofrequency ablation (RFA) in the management of hypersplenism is still under study, and the current literature is sparse. This case report not only presents splenic RFA as an attractive alternative treatment for hypersplenism induced by liver cirrhosis, but also shows that it appears to be a viable, safe and promising option for these patients.