1998 Volume 34 Issue 7 Pages 1175-1179
The patient, an ten-year-old boy, was first admitted to the hospital at the age of 4 because of progressive anemia and splenomegaly, and diagnosed to have extrahepatic portal hypertension. He was treated with repeated endoscopic sclerotherapies (EIS) to esophageal varices and a partial splenic embolization (PSE) to hypersplenism for a subsequent four years. It gradually became difficult to control his refractory hemorrhagic episodes with palliative interventions. At the age of eight, splenorenal shunt with splenectomy was selected as a surgical intervention to control gastrointestinal bleeding. After that, he has been apparently well without any signs of encephalopathy. We think that the surgical approach consisting of porto-systemic shunting and splenectomy is one of the definitive maneuvers for patients with refractory hemorrhagic complications after EIS and PSE, especially in children more than 6 years old.
