Abstract
Two patients of liver cirrhosis with hypersplenism, large splenomegaly and esophageal varices were successfully treated by endoscopic injection sclerotherapy (EIS) with preoper-ative partial splenic embolization (PSE) The platelet mean count rose significantly soon after the PSE, however, it was back to normal level within about four weeks, and was remaining at this range, when the EIS was carried out. The patients were followed for eighteen months after the PSE showing a fairly good response on peripheral blood count, bleeding tendency and blood chemistry of liver func-tion. According to selective arteriogram, the pre-PSE dilated splenic artery narrowed after PSE, and in contrast the hepatic artery became dilated. The abdominal computed tomo-graphy revealed the enlarged spleen became peripheraly infarcted and contracted to significant degree. These findings led us to surmise that the distribution of splanchnic blood flow was altered markedly by the PSE. The bluish esophageal varices with positive red colour sign changed to withish ones with negative red colour sign after PSE, and there was no severe esophageal bleeding thereafter We believe the PSE was performed preoperatively not only to decrease esophageal bleeding during the EIS but to ameliorate the hypersplenism and the liver function.
