Skip to main content
SpringerLink
Log in

Splenomegaly in Portal Hypertension: Causes and Effects

  • Chapter
Portal Hypertension

  • 514 Accesses

Abstract

The spleen has long been a mysterious organ whose function was unknown. Anatomic descriptions of the spleen are found in the works of Aristotle, Hippocrates, in the Talmud and the Bible [1], but its function has only been investigated and understood in the last hundred years.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rosner F (1977) Medicine in the Bible and the Talmud. Ktav Publishing House Inc, Yeshiva University Press, New York, pp 86–90

    Google Scholar 

  2. Reynolds TB (1987) Portal hypertension. In: Schiff L, Schiff ER (eds) Diseases of the liver, 6th edn. Lippincott, Philadelphia, pp 875–902

    Google Scholar 

  3. Sherlock S (1985) Portal hypertension. In: Diseases of the liver and biliary system, 7th edn. Blackwell, London, p 139

    Google Scholar 

  4. Ham AW, Cormack DH (1979) Histology, 8th edn. JB Lippincott, Philadelphia, pp 355–366

    Google Scholar 

  5. Coetze T (1982) Clinical anatomy and physiology of the spleen. S Afr Med J 62: 746–757

    Google Scholar 

  6. Krumbharr EB, Lippincott SW (1939) The postmortem weight of the normal human spleen at different ages. Am J Med Sci 197: 344–349

    Google Scholar 

  7. Moschcowitz E (1948) The pathogenesis of splenomegaly in hypertension of the portal circulation: “Congestive splenomegaly”. Medicine (Baltimore) 27: 187–221

    CAS  Google Scholar 

  8. Liebovitz HR (1963) Splenomegaly and hypersplenism pre and post portacaval shunt. NY State J Med 63: 2631–2640

    Google Scholar 

  9. Walker RM (1952) The pathology and treatment of portal hypertension. Lancet I: 729–735

    Google Scholar 

  10. Itzchak Y, Glickman MG (1977) Splenic vein thrombosis in patients with a normal size spleen. Invest Radiol 12: 158–160

    PubMed  CAS  Google Scholar 

  11. McNee JW (1931) The spleen, its structure, function and diseases. Lancet I: 951, 1009, 1063

    Google Scholar 

  12. Ravenna P (1940) Splenoportal venous obstruction with splenomegaly. Arch Int Med 66: 879–890

    Google Scholar 

  13. Liebovitz HR (1959) The spleen in portal hypertension. In: Bleeding esophageal varices: Portal hypertension. Springfield, New York, p 211

    Google Scholar 

  14. Rousselot LM (1939) Congestive splenomegaly (Band’s syndrome) Bull NY Acad Med 15: 188–201

    CAS  Google Scholar 

  15. Kito H (1987) Experimental study on splenomegaly after partial hepatectomy (abstract in English). Nippon Geka Gakkai Zasshi 88: 1604–1618

    PubMed  CAS  Google Scholar 

  16. Wanless IR, Bernier V (1983) Fibrous thickening of the splenic capsule. A response to chronic splenic congestion. Arch Path Lab Med 107: 595–599

    CAS  Google Scholar 

  17. Saitoh K, Kamiyama R, Hatakeyama S (1986) In vitro labeling and tissue autoradiography of splenomegaly associated with portal hypertension. Virchows Arch [B] 52: 33–40

    CAS  Google Scholar 

  18. Re G, Casali AM, Cavalli D (1986) Histometric analysis of white pulp arterial vessels in congestive splenomegaly. Appl Pathol 4: 98–103

    PubMed  CAS  Google Scholar 

  19. Cavalli G, Re G, Casali AM (1984) Red pulp arterial terminals in congestive splenomegaly. A morphometric study. Appl Pathol 4: 98–103

    Google Scholar 

  20. Rozga J, Jeppson B, Hagerstrand B, Bengmark S (1985) Acute portal vein stenosis. Acta Chir Scand 151: 123–131

    Google Scholar 

  21. Cameron GR, Desaram GS (1939) A method for permanently dissociating the spleen from the portal circulation and its use in the study of experimental cirrhosis. J Path Bact 48: 41–49

    Google Scholar 

  22. Dumont AE, Becker FF, Warren KS, Martelli AB (1975) Regulation of spleen growth and portal pressure in hepatic schistosomiasis. Am J Pathol 78: 211–215

    PubMed  CAS  Google Scholar 

  23. Dumont AE, Becker FF, Jacobs HS (1974) Regulation of spleen growth in hepatic dysfunction. Ann Surg 179: 465–471

    PubMed  CAS  Google Scholar 

  24. Berman L, Axelrod AR, Horan TN, Jacobsohn SD, Sharp EA, Vonderheide EC (1949) The blood and bone marrow in patients with cirrhosis of the liver. Blood 4: 511–533

    PubMed  CAS  Google Scholar 

  25. Buligesco L, Popovici A, Bogathy I, Cutardachec C (1975) L’hypersplenisme et l’hypertension portale. Acta Gastroenterol Belg 38: 361–372

    PubMed  CAS  Google Scholar 

  26. Felix WR, Myerson RM, Sigel B, Perrin EB, Jackson FC (1974) The effect of portocaval shunt on hypersplenism. Surg Gynecol Obstetr 139: 899–904

    Google Scholar 

  27. Mutchnick MG, Lerner E, Conn HO (1980) Effect of portacaval anastomosis on hypersplenism. Dig Dis Sci 25: 929–938

    PubMed  CAS  Google Scholar 

  28. Henderson JM, Warren WD (1986) A method of measuring quantitative hepatic function and hemodynamics in cirrhosis: The changes following distal splenorenal shunt. Jpn J Surg 16: 157–168

    PubMed  CAS  Google Scholar 

  29. Dumont AE, Amorosi E, Stahl W (1970) Significance of splenomegaly in patients with hepatic cirrhosis and bleeding esophageal varices. Ann Surg 171: 522–526

    PubMed  CAS  Google Scholar 

  30. Schlichting P, Christensen E, Andersen PK (1983) Prognostic factors in cirrhosis identified by Cox’s regression model. Hepatology 3: 889–895

    PubMed  CAS  Google Scholar 

  31. Okuda K, Kono K, Ohnishi K, Kimura K, Omata M, Koen H, Nakajima Y, Musha H, Hirashima T, Takashi M, Takayasu K (1984) Clinical study of 86 cases of idiopathic portal hypertension and comparison with cirrhosis with splenomegaly. Gastroenterology 86: 600–610

    PubMed  CAS  Google Scholar 

  32. Kameda H, Yamazaki K, Imai F, Sugiura M, Nakashima T, Okuda K (1986) Obliterative portal venopathy: A comparative study of 184 cases of extrahepatic portal obstruction and 469 cases of idiopathic portal hypertension. J Gastroenterol Hepatol 1: 139–149

    Google Scholar 

  33. Peters PE, Lorenz R, Fischer M (1983) Splenic imaging. Lymphology 16: 90–100

    PubMed  CAS  Google Scholar 

  34. Price DC (1983) Spleen: Nuclear medicine. In: Margulis AR, Burhenne JH (eds) Alimentary tract radiology. Mosby, St Louis

    Google Scholar 

  35. Sigel RM, Becker DV, Hurley JK (1970) Evaluation of spleen size during routine liver imaging with Tc 99m and the scintillation camera. J Nucl Med 11: 689–693

    PubMed  CAS  Google Scholar 

  36. Butterman G (1987) Radionuclide scanning in cirrhosis. In: Boyer JL, Bianchi L (eds) Liver cirrhosis. Falk symposium 44 MTP Press, Lancaster, pp 215–221

    Google Scholar 

  37. Eddieston AL, Blendis LM, Osborn SB, Williams R (1969) Significance of increased splenic uptake on liver scintiscanning. Gut 10: 711–716

    Google Scholar 

  38. Simon TR, Neuman RL, Goralik F, Riely C, Hoffer P, Gottschalk A (1981) Scintigraphic diagnosis of cirrhosis. A receiver operator characteristic analysis of the common interpretative criteria. Radiology 138: 723–726

    CAS  Google Scholar 

  39. Burhenne R (1983) Spleen: overview. In: Margulis AR, Burhenne HJ (eds) Alimentary tract radiology. Mosby, St Louis

    Google Scholar 

  40. Blendis LM, Williams R, Kreel L (1969) Radiological determination of spleen size. Gut 10: 433–435

    PubMed  CAS  Google Scholar 

  41. Koga T (1979) Correlation between sectional area of the spleen by ultrasonic tomography and actual volume of the removed spleen. JCU 7: 119–120

    PubMed  CAS  Google Scholar 

  42. Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980) Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. Radiology 137: 727–729

    PubMed  CAS  Google Scholar 

  43. Friedman AC (1987) Magnetic resonance imaging of the spleen. In: Radiology of the liver, biliary tract, pancreas and spleen. Williams and Wilkins, Baltimore, pp 1031–1034

    Google Scholar 

  44. Blendis LM, Kreel L, Williams R (1969) The celiac axis and its branches in splenomegalies and liver disase. Gut 10: 85–90

    PubMed  CAS  Google Scholar 

  45. Williams R, Kreel L, Blendis LM (1967). Celiac axis catheterization: uses and value in portal hypertension. In: Read AE (ed) The liver. Butterworth, London, pp 125-135

    Google Scholar 

  46. Zamir O, Mogle P, Lernau O, Nissan S (1984) Splenoportography. A reappraisal. Am J Gastroenterol 79: 283–286

    CAS  Google Scholar 

  47. Atkinson M, Sherlock S (1954) Intra-splenic pressure as index of portal venous pressure. Lancet I: 1325–1327

    Google Scholar 

  48. Williams R, Condon RE, Williams HS, Blendis LM, Kreel L (1968) Splenic blood flow in cirrhosis and portal hypertension. Clin Sci 34: 441–452

    PubMed  CAS  Google Scholar 

  49. Sato S, Ohnishi K, Sugita S, Okuda K (1987) Splenic artery and superior mesenteric artery blood flow: Non-surgical Doppler ultrasound measurement in healthy subjects and patients with chronic liver disease. Radiology 164: 347–352

    PubMed  CAS  Google Scholar 

  50. McPherson AIS, Richmond J, Stuarr AE (1973) The spleen. In: Thomas CC (ed), Springfield

    Google Scholar 

  51. Zetterstroem B (1973) Evaluation of the Xenon 133 clearance method for measurement of blood flow in the dog spleen. Acta Chir Scand 139: 27–33

    Google Scholar 

  52. Ohnishi K, Saito M, Sato S, Terabayashi H, Iida S, Nomura F, Nakano M, Okuda K (1987) Portal hemodynamics in idiopathic portal hypertension (Banti’s syndrome). Gastroenterology 92: 751–758

    PubMed  CAS  Google Scholar 

  53. Gitlin N, Grahame GR, Williams HS, Sherlock S (1970) Splenic blood flow and resistance in patients with cirrhosis before and after portocaval shunt. Gastroenterology 59: 208–213

    PubMed  CAS  Google Scholar 

  54. Witte C, Witte MH, Renert W, Corrigan JJ (1974) Splenic circulatory dynamics in congestive splenomegaly. Gastroenterology 67: 498–505

    PubMed  CAS  Google Scholar 

  55. Merkel C, Gatta A, Arnaboldi L, Zuin R (1985) Splenic hemodynamics and portal hypertension in patients with liver cirrhosis and spleen enlargement. Clin Physiol 5: 531–539

    PubMed  CAS  Google Scholar 

  56. Kontos HA, Shapiro W, Mauck P, Patterson J (1964) General and regional circulatory alterations in cirrhosis of the liver. Am J Med 37: 526–535

    PubMed  CAS  Google Scholar 

  57. Vorobioff J, Bredfeld JE, Groszmann RJ (1984) Increased blood flow through the portal system in cirrhotic rats. Gastroenterology 87: 1120–1126

    PubMed  CAS  Google Scholar 

  58. Benoit JN, Womack WA, Hernandez L, Granger DN (1985) “Forward” and “Backward” flow mechanisms of portal hypertension. Gastroenterology 89: 1092–1096

    PubMed  CAS  Google Scholar 

  59. Thompson WP, Caughey JL, Wipple AL, Rousselot LM (1937) Splenic vein pressure in congestive splenomegaly (Banti’s syndrome). J Clin Invest 16: 571–572

    PubMed  CAS  Google Scholar 

  60. Mikkelsen WP, Edmonson HA, Peters RL, Reddeker AG, Reynolds TB (1965) Extra and intrahepatic portal hypertension without cirrhosis (hepatoportal sclerosis). Ann Surg 162: 602–620

    PubMed  CAS  Google Scholar 

  61. Okuda K, Nakajima T, Kameda H, Sugiura M, Ohnishi K, Tokabayashi M (1985) Idiopathic non-cirrhotic portal hypertension: A national study. In: Brunner H, Thaler H (eds) A Festschrift for Hans Popper. Raven, New York, pp 95–108

    Google Scholar 

  62. Basu AK, Boyer J, Bhattacharya R, Basu Mallick KC, Sen Gupta KP (1967) Noncirrhotic portal fibrosis with portal hypertension: A new syndrome 1. Clinical and function studies and results of operation. Indian J Med Res 55: 336–350

    PubMed  CAS  Google Scholar 

  63. Sama SK, Bhargava S, Gopinath N (1971) Noncirrhotic portal fibrosis. Am J Med 51: 160–169

    PubMed  CAS  Google Scholar 

  64. Sarin SK (1989) Noncirrhotic portal fibrosis. Gut 30: 406–415

    PubMed  CAS  Google Scholar 

  65. Williams R, Parsonson A, Somers K, Hamilton PJS (1966) Portal hypertension in idiopathic tropical splenomegaly. Lancet I: 329–333

    Google Scholar 

  66. Ueda H, Kitani K, Kameda H (1971) Splenic blood flow in idiopathic portal hypertension in Japan measured by Kr85 clearance method. Acta Hepatospleno 18: 28–40

    CAS  Google Scholar 

  67. Donovan AJ, Reynolds TB, Mikkelsen WP, Peters RL (1969) Systemic portal arteriovenous fistulas: Pathological and hemodynamic observations in two patients. Surgery 66: 474–482

    PubMed  CAS  Google Scholar 

  68. Stone HH, Jordan WD, Acker J, Martin JD (1965) Portal arteriovenous fistula. Am J Surg 109: 191–205

    PubMed  CAS  Google Scholar 

  69. Van Way CW, Crane JM, Riddell DH, Foster JH (1971) Arteriovenous fistula in the portal circulation. Surgery 70: 876–890

    PubMed  Google Scholar 

  70. Sugita S, Ohnishi K, Saito M (1987) Splanchnic hemodynamics in portal hypertensive dogs with portal fibrosis produced by intraportal injection of killed non-pathogenic colon bacilli. Am J Physiol 252: G748–754

    PubMed  CAS  Google Scholar 

  71. Shaldon S, Sherlock S (1962) Portal hypertension in the myeloproliferative syndromes and the reticuloses. Am J Med 32: 758–764

    PubMed  CAS  Google Scholar 

  72. Oishi N, Swisher SN, Stormart JM, Schwartz SI (1960) Portal hypertension in myeloid metaplasia. Arch Surg 81: 98–104

    Google Scholar 

  73. Silverstein MN, Wollaeger EE, Baggenstoss AH (1973) Gastrointestinal and abdominal manifestations of agnogenic myeloid metaplasia. Arch Int Med 131: 532–537

    CAS  Google Scholar 

  74. Blendis LM, Banks DC, Ramboer C, Williams R (1970) Spleen blood flow and splanchnic hemodynamics in blood dyscrasia and other splenomegalies. Clin Sci 38: 73–84

    PubMed  CAS  Google Scholar 

  75. Datta DV, Grover SL, Saini VK, Datta BN (1975) Portal hypertension in chronic leukemia. Br J Haematol 31: 279–285

    PubMed  CAS  Google Scholar 

  76. Lima JP, von Eye G, de Lima CP, Ludwig OK (1962) Portal venous pressure in Hodgkin’s disease with hepatic involvement and esophageal varices. Am J Med 32: 618–620

    Google Scholar 

  77. Lindor K, Rakela J, Perrault J, Van Heerden J (1987) Non-cirrhotic portal hypertension due to lymphoma. Reversal following splenectomy. Dig Dis Sci 32: 1056–1058

    PubMed  CAS  Google Scholar 

  78. Sales J, Hunt AH (1970) Gaucher’s disease and portal hypertension. Br J Surg 57: 225–230

    PubMed  CAS  Google Scholar 

  79. Grundfest S, Copperman AM, Ferguson R, Benjamin S (1980) Portal hypertension associated with systemic mastocytosis and splenomegaly. Gastroenterology 78: 370–373

    PubMed  CAS  Google Scholar 

  80. Denison EK, Peters RL, Reynolds TB (1971) Portal hypertension in a patient with osteopetrosis. A case report with a discussion of a mechanism of portal hypertension. Arch Intern Med 128: 179–183

    Google Scholar 

  81. Pitlik S, Cohen L, Hadar H, Srulijes C, Rosenfeld JB (1977) Portal hypertension and esophageal varices in hemangiomatosis of the spleen. Gastroenterology 72: 937–940

    PubMed  CAS  Google Scholar 

  82. Tada S, Shin M, Takashima T, Noguchi M, Nishio I, Miyake A, Matsubara F (1972) Diffuse capillary hemangiomatosis of the spleen as a cause of portal hypertension. Radiology 104: 63–64

    PubMed  CAS  Google Scholar 

  83. Lukie BE, Card RT (1977) Portal hypertension complicating myelofibrosis: Reversal following splenectomy. Can Med Assoc J 117: 771–772

    PubMed  CAS  Google Scholar 

  84. Belli L, Puttini M, Marni A (1980) Extrahepatic portal obstruction: clinical experience and surgical treatment in 105 patients. J Cardiovasc Surg 21: 439–448

    CAS  Google Scholar 

  85. Hamilton DW, Hunt AH (1970) Extrahepatic portal obstruction. Med J Aust 1: 493–499

    PubMed  CAS  Google Scholar 

  86. Novis BH, Duys P, Barbezat GO (1976) Fibreoptic endoscopy and the use of the Sengstaken tube in acute gastrointestinal hemorrhage in patients with portal hypertension and varices. Gut 17: 258–263

    PubMed  CAS  Google Scholar 

  87. Babb RR (1976) Splenic vein obstruction: A curable cause of variceal bleeding. Am J Dig Dis 21: 512–513

    PubMed  CAS  Google Scholar 

  88. Madsen MS, Petersen TH, Sommer H (1986) Segmental portal hypertension. Ann Surg 204: 72–77

    PubMed  CAS  Google Scholar 

  89. Mahmoud AF, Woodrug AW (1978) The causation of splenomegaly in schistosomiasis in mice. Clin Sci Mol Med 54: 397–401

    PubMed  CAS  Google Scholar 

  90. Blendis LM (1969) Hypersplenism in cirrhosis. Postgrad Med J 45: 223–226

    PubMed  CAS  Google Scholar 

  91. Hutson DG, Zeppa R, Levy JU, Schiff ER, Livingstone AS, Fink P (1977) The effect of the distal splenorenal shunt on hypersplenism. Ann Surg 185: 605–612

    PubMed  CAS  Google Scholar 

  92. Soper NJ, Rikkers LF (1982) Effect of operations for variceal hemorrhage on hypersplenism. Am J Surg 144: 700–703

    PubMed  CAS  Google Scholar 

  93. Jorgensen B, Fischer E, Ingeberg S (1984) Decreased blood platelet volume and count in patients with liver disease. Scand J Gastroenterol 19: 492–495

    PubMed  CAS  Google Scholar 

  94. Achiron A, Luboshits J, Halevy J (to be published) White cell count in liver cirrhosis. Arch Intern Med

    Google Scholar 

  95. Schaffner A, Augustini N, Otto RC, Fehr J (1985) The hypersplenic spleen. A contractile reservoir of granulocytes and platelets. Arch Int Med 145: 651–654

    CAS  Google Scholar 

  96. Blendis LM, Clarke MB, Williams R (1969) Effect of splenectomy on the hemodilutional anemia of splenomegaly. Lancet I: 795–798

    Google Scholar 

  97. Pryor DS (1967) The mechanism of anemia in tropical splenomegaly. Q J Med 143: 337–356

    Google Scholar 

  98. Pettit JE, Williams ED, Glass HI, Lewis SM, Szur L, Wicks CJ (1971) Studies of splenic function in the myeloproliferative disorders and generalized malignant lymphomas. Br J Haematol 20: 575–578

    PubMed  CAS  Google Scholar 

  99. Pitcher CS, Williams R (1963) Reduced red cell survival in jaundice and its relation to abnormal glutathione metabolism. Clin Sci 24: 239–243

    PubMed  CAS  Google Scholar 

  100. Prankerd AJ (1963) The spleen and anemia. Br Med J 2: 517–525

    PubMed  CAS  Google Scholar 

  101. Schreiber HW (1962) Klinische und tierexperimentelle Untersuchungen zum Verhalten der splenopathischen Blutzell-depression Hypersplenismus nach Durchführung einer portocavalen Anastomose. Langebecks Arch Chir 300: 669–691

    CAS  Google Scholar 

  102. Thomas HC, McSween RN, White RG (1973) Role of the liver in controlling the immunogenicity of commensal bacteria in the gut. Lancet I: 1288–1291

    Google Scholar 

  103. Triger D, Wright R (1973) Hyperglobulinemia in liver disease. Lancet I: 1494–1496

    Google Scholar 

  104. Martinez E, Menendez AR, Ablanedo P (1986) Splenic artery aneurysms. Int Surg 71: 95–99

    PubMed  CAS  Google Scholar 

  105. de Vries JE, Schattenkerk ME, Malt RA (1982) Complications of splenic artery aneurysms other than intraperitoneal rupture. Surgery 91: 200–204

    PubMed  Google Scholar 

  106. Thiis JC, Schneider AJ, Van Kordelaar JM (1883) Spontaneous rupture of the spleen complicating portal hypertension. Intensive Care Med 9: 299–300

    Google Scholar 

  107. Almgren B, Bowald S (1983) Spontaneous rupture of the splenic vein secondary to hepatic cirrhosis. Acta Chir Scand 149: 109–111

    PubMed  CAS  Google Scholar 

  108. Wexler MJ, McLean LD (1975) Massive spontaneous portosystemic shunting without varices. Arch Surg 110: 995–1003

    PubMed  CAS  Google Scholar 

  109. Dilawari JB, Raju GS, Chaiwla YK (1989) Development of large splenoadrenorenal shunt after endoscopic sclerotherapy. Gastroenterology 97: 421–426

    PubMed  CAS  Google Scholar 

  110. Keith RG, Mustard RA, Saibil EA (1982) Gastric variceal bleeding due to occlusion of splenic vein in pancreatic disease. Can J Surg 25: 301–304

    PubMed  CAS  Google Scholar 

  111. Jones KB, Koss PTD (1984) Postembolization splenic abscess in a patient with pancreatitis and splenic vein thrombosis. South Med J 77: 390–393

    PubMed  CAS  Google Scholar 

  112. Marshall JP, Smith PD, Hoyumpa AM (1977) Gastric varices: Problem in diagnosis. Am J Dig Dis 22: 947–955

    PubMed  Google Scholar 

  113. Salaam AA, Warren WD, Tyras DH (1973) Splenic vein thrombosis: a diagnosable and curable form of portal hypertension. Surgery 74: 961–972

    Google Scholar 

  114. Banti G (1883) Dell anemica splenica. Arch Scuola Anat Patol Florence 2: 53–59

    Google Scholar 

  115. Pemberton JJ, Kierman P (1945) Surgery of the spleen. Surg Clin North Am Aug: 800-809

    Google Scholar 

  116. Blakemore AH, Fitzpatrick HF (1951) The surgical management of the post splenectomy bleeder with extrahepatic portal hypertension. Ann Surg 134; 420–430

    PubMed  CAS  Google Scholar 

  117. Miller EM, Hagedorn AB (1951) Results of splenectomy. A follow-up study of 140 consecutive cases. Ann Surg 134: 815–819

    PubMed  CAS  Google Scholar 

  118. Shumaker HB Jr, King H (1952) Splenic studies. 2. Portal hypertension in children associated with gastroesophageal hemorrhage. Arch Surg 65: 461–499

    Google Scholar 

  119. Hassab MA (1970) Non-shunt operations for portal hypertension without cirrhosis. Surg Gynecol Obst 131: 648–652

    CAS  Google Scholar 

  120. Johnson G Jr, Womack NA, Gabriele OF, Peters RM (1969) Control of hyperdynamic circulation in patients with bleeding esophageal varices. Ann Surg 169: 661–669

    PubMed  Google Scholar 

  121. Smith GV (1970) Splenectomy and coronary vein ligation for the control of bleeding esophageal varices. Am J Surg 110: 122–127

    Google Scholar 

  122. Sugiura M, Futagawa S (1973) A new technique for treating esophageal varices. J Cardiovasc Surg (Torino) 66: 677–680

    CAS  Google Scholar 

  123. Akita H, Sakoda K (1980) Portopulmonary shunt by splenopneumopexy as a surgical treatment of Budd-Chiari syndrome. Surgery 87: 85–94

    PubMed  CAS  Google Scholar 

  124. Ono J, Katsuki T, Kodama Y (1987) Combined therapy for esophageal varices: Sclerotherapy, embolization, and splenopneumopexy. Surgery 101: 535–543

    PubMed  CAS  Google Scholar 

  125. Krivit W, Geibing GS, Leonard A (1979) Overwhelming post splenectomy infection. Surg Clin North Am 59: 223–233

    PubMed  CAS  Google Scholar 

  126. Dumont AE, Berman IR, Stahl W (1972) Significance of an enlarged splenic artery in patients with bleeding varices. Ann Surg 175: 466–472

    PubMed  CAS  Google Scholar 

  127. Del Guercio LKM, Cohn JD, Kazarian KK (1978) A shunt equation for estimating the splenic component of portal hypertension. Am J Surg 135: 70–75

    PubMed  Google Scholar 

  128. Zannini G, Masciarello S, Pagano G (1983) Percutaneous splenic artery occlusion for portal hypertension. Arch Surg 118: 897–900

    PubMed  CAS  Google Scholar 

  129. Alwmark A, Bengmark S, Gullstrand P, Joelsson B, Lunderquist A, Owman T (1982) Evaluation of splenic embolization in patients with portal hypertension and hypersplenism. Ann Surg 196: 518–524

    PubMed  CAS  Google Scholar 

  130. El-khishen M, Henderson JM, Millikan WJ Jr, Kutner MH, Warren WD (1985) Splenectomy is contraindicated for thrombocytopenia secondary to portal hypertension. Surg Gynecol Obstet 160: 233–238

    PubMed  CAS  Google Scholar 

  131. Owman T, Lunderquist A, Alwmark A, Borjesson B (1979) Embolization of the spleen for treatment of splenomegaly and hypersplenism in patients with portal hypertension. Invest Radiol 4: 457–464

    Google Scholar 

  132. Vazquez Estevez J, Lassaletta L, Perez Higueras A, Utrilla J, Diez Pardo A (1988) Partial splenic embolization in hypersplenism. Acta Paediatr Scand 77: 593–596

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, M5G 1L7, Canada

    Laurence M. Blendis

Authors
  1. Gilles A. Morali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laurence M. Blendis
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Medicine, Chiba University Hospital, Inohana 1-8-1, Chiba, 280, Japan

    Kunio Okuda M.D., Ph.D. (Professor) (Professor)

  2. Department of Hepatology, Hopital Beaujon, 92118, Clichy, France

    Jean-Pierre Benhamou M.D. (Professor) (Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer Japan

About this chapter

Cite this chapter

Morali, G.A., Blendis, L.M. (1991). Splenomegaly in Portal Hypertension: Causes and Effects. In: Okuda, K., Benhamou, JP. (eds) Portal Hypertension. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68361-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-68361-2_7

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68363-6

  • Online ISBN: 978-4-431-68361-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation