A Case of Rapidly Developed Splenomegaly after Percutaneous Transhepatic Obliteration (PTO)

A 70-year-old woman underwent Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for bleeding gastric varices, which was unsuccessful. Then, she underwent Percutaneous Transhepatic Obliteration (PTO) to block the main blood supply route. On the 5th postoperative day, the white blood cell and platelet counts suddenly fell markedly, and CT showed that the splenomegaly had worsened rapidly after PTO. Since blood flow to the gastric varices was still present, Partial Splenic Embolization (PSE) was performed in an attempt to reduce portal venous blood flow. However, rebleeding from the gastric varices occurred, and so embolization with Histoacryl was performed. Although portal hypertension after PTO is a relatively common event, we report this case because no case has been reported in which massive splenomegaly with leukocytopenia developed within a short period of time.