Radiofrequency ablation for treatment of hypersplenism: A feasible therapeutic option.

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.

Splenectomy in a patient with treatment-resistant visceral leishmaniasis: a case report.

Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan (Leishmania) and, in its classic form, is a serious illness associated with malnutrition, anemia, hepatosplenomegaly, infectious processes and coagulopathies. The effect of splenectomy in patients with visceral leishmaniasis is not well defined; however, it is known that the spleen is the largest reservoir of infected cells belonging to the reticulo endothelial system. Therefore, the surgical procedure is an option for the debulking of parasites, providing a cure for refractory VL and minimizing the complications of hypersplenism.

Splenectomy in a patient with treatment-resistant visceral leishmaniasis: a case report / A esplenectomia na leishmaniose visceral refratária ao tratamento clínico: relato de caso

Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan (Leishmania) and, in its classic form, is a serious illness associated with malnutrition, anemia, hepatosplenomegaly, infectious processes and coagulopathies. The effect of splenectomy in patients with visceral leishmaniasis is not well defined; however, it is known that the spleen is the largest reservoir of infected cells belonging to the reticulo endothelial system. Therefore, the surgical procedure is an option for the debulking of parasites, providing a cure for refractory VL and minimizing the complications of hypersplenism.

A leishmaniose visceral (LV) ou calazar é uma infecção sistêmica causada por um protozoário (Leishmania) e na sua forma clássica é uma doença grave. Cursa com desnutrição, anemia, hepatoesplenomegalia, processos infecciosos e coagulopatias. O papel da esplenectomia em pacientes com leishmaniose visceral não é bem definido; entretanto, sabe-se que o baço é o maior reservatório de células parasitadas do sistema reticulo endotelial e o procedimento cirúrgico é, dessa forma, uma opção para debulking de parasitas, propiciando a cura da LV refratária e minimizando as complicações do hiperesplenismo.

Fatal relapse of hyperreactive malarial splenomegaly (HMS) in a 10-year old Nigerian female--a case report.

BACKGROUND: The Hyperreactive Malarial Splenomegaly Syndrome (HMS) originally called the tropical splenomegaly syndrome (TSS) or Big spleen disease refers to cases of splenomegaly in the tropics for which no cause was found despite thorough investigation. It is restricted to the malarial belt, yet there are few reports on HMS in Nigeria, probably due to a low index of suspicion and non-availability of laboratory facilities to determine titres of malarial antibodies. The objective of this paper is to highlight the features, management, risk of relapse and prognosis of HMS. METHOD/RESULT: We present a 10-year old female with recurrent massive splenomegaly with previous clinical response to antimalarials and evidence of hypersplenism. CONCLUSION: HMS should be suspected in any child with moderate to massive splenomegaly with evidence of hypersplenism and clinical response to antimalarials.

Portal hypertension and hypersplenism in pregnancy secondary to chronic schistosomiasis. A case report.

In this country, Schistosoma mansoni infections are seen rarely since the distribution of schistosomes in humans is governed by the range of their molluscan hosts. The snail hosts of S. mansoni reside in fresh waters of tropical zones. A native of Brazil was seen in her second trimester of pregnancy with marked splenomegaly and hypersplenism. Thirteen years before she had been treated for schistosomiasis, and she had been well until her pregnancy. Studies were done to rule out other causes of splenomegaly and hypersplenism. Esophageal endoscopy confirmed the presence of esophageal varices. The main risk to these patients is severe, sometimes fatal gastrointestinal bleeding. In our patient this risk was compounded by marked thrombocytopenia. Splenectomy was performed, and a liver biopsy confirmed the presence of S. mansoni eggs.