A Case of Cryptogenic Liver Cirrhosis with Huge Splenomegaly

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Abstract

Introduction We never knew how the liver function goes after splenectomy in case of huge splenomegaly because of the dramatic portal flow alteration. In this report, we will present a case of cryptogenic liver cirrhosis with huge splenomegaly. Case presentation A 14 years old male was admitted with huge splenemogaly and hepatomegaly. Computed tomography showed enlarged liver and huge spleen that occupied large volume of abdominal and pelvic cavity. His ADL was significantly deteriorated, and the patient could not stand up because of exertional dyspnea. Although the etiology of the patient was not determined in spite of several liver biopsies and laboratorial tests, we planned splenectomy to improve his ADL. Also, the progression of liver insufficiency was expected because the portal flow could be dramatically changed after the removal of the huge spleen. Therefore, we prepared for the living donor liver transplantation at first, and then splenectomy was performed. After the first operation, his general condition was improved and the liver function was not deteriorated for 6 months. Unfortunately, rapid progression of jaundice from his primary disease was occurred, and living donor liver transplantation using left lobe graft from his mother was performed 4 months later. The patient survived the two-stage liver transplantation procedure without major complications. Conclusion Our case suggests that we should consider the possibility of liver deterioration after splenectomy for the huge splenomegaly. In case of rapid deterioration of liver function, liver transplantation is the only feasible option.

弘前医学. 64(Suppl.), 2013, p.S113-S116

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  • 弘前医学

    弘前医学 64 (Supplement), S113-S116, 2013-04-02

    弘前大学大学院医学研究科・弘前医学会

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