Treatment of hypersplenism requires medical management of the primary disease. Splenectomy is associated with significant post-operative morbidity, increased risk of portal vein thrombosis, infections by encapsulated organisms and worsening hepatic encephalopathy when hypersplenism is due to cirrhosis. Partial splenic artery embolization (embolization of about 40-80% of the splenic tissue) is a better option as the risk of infections and worsening of liver function is reduced as some functioning splenic tissue is preserved. The rise in blood counts usually occurs within two weeks after the procedure. Post-embolization syndrome is the commonest complication encountered in more than 75% of the patients [1,2]. It begins after 24 to 48 hours and lasts for several days. It is self-limited and is managed conservatively. Other complications include pancreatitis, left sided pleural effusion, portal vein thrombosis and splenic abscess [3]. Mortality rate is around 0-6% [1].

Acknowledgements: Dr Santhosh Joseph, Professor and Head of Interventional Radiology and team for performing the procedure; Dr Shuba, Professor and Head of Pediatric Intensive Care Unit and team for post-operative management; and Dr Thambarasi, Junior resident for overall patient management.

1. Hadduck TA, McWilliams JP. Partial splenic artery embolization in cirrhotic patients. World J Radiol. 2014;6:160-8.

2. Smith M, Ray CE. Splenic artery embolization as an adjunctive procedure for portal hypertension. Semin Intervent Radiol. 2012;29:135-9.