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May 1966

Vasopressin as an Adjunct to Splenoportography

Arch Surg. 1966;92(5):802-804. doi:10.1001/archsurg.1966.01320230150027

SPLENOPORTOGRAPHY has often provided valuable diagnostic information essential to the management of patients with portal hypertension,1 intrahepatic tumors,2 and lesions of the pancreas.3 However, enthusiasm for this procedure has been dampened by occasional, but disturbing complications.

The most serious of these complications of percutaneous splenoportography has been intraperitoneal hemorrhage requiring splenectomy, reported to occur with a frequency of from 0.2 to 2.2%.4,5 Such hemorrhage usually resulted from a superficial tear in the splenic capsule secondary to the puncture and injection of contrast media. This complication has been almost always observed in patients with elevated portal pressures.6

The present study was directed at confirming the importance of elevated portal pressure in the development of severe bleeding following splenic puncture and to evaluate the effect of vasopressin on (1) bleeding from the splenic puncture site and (2) radiographic definition of the portal system.

Materials and Methods  A