Portal Hypertension and Spleen Surgery

What is portal hypertension?
Portal hypertension is an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to the liver). The increase in pressure is caused by a blockage in the blood flow through the liver. Increased pressure in the portal vein causes large veins (varices) to develop across the esophagus and stomach to get around the blockage. The varices become fragile and can bleed easily.

What causes portal hypertension?
The most common cause of portal hypertension is cirrhosis or scarring of the liver. Cirrhosis results from the healing of a liver injury caused by hepatitis, alcohol abuse, or other causes of liver damage. In cirrhosis, the scar tissue blocks the flow of blood through the liver and slows its processing functions.

Portal hypertension may also be caused by thrombosis or a blood clot that develops in the portal vein.

What are the symptoms of portal hypertension?
The onset of portal hypertension may not always be associated with specific symptoms that identify what is happening in the liver. But if you have liver disease that leads to cirrhosis, the chance of developing portal hypertension is high.

The main symptoms and complications of portal hypertension include:

Gastrointestinal bleeding: Black, tarry stools or blood in the stools; or vomiting of blood due to the spontaneous rupture and bleeding from varices.
Ascites: An accumulation of fluid in the abdomen.
Encephalopathy: Confusion and forgetfulness caused by poor liver function and the diversion of blood flow away from your liver. Reduced levels of platelets or decreased white blood cell count.
 

What is Spleen Removal?

Your spleen is a small organ located on the left side of your abdomen under the rib cage. This organ is part of your immune system and helps to fight off infections while also filtering damaged and old cells out of your bloodstream. If your spleen needs to be removed, you’ll undergo a surgical procedure called a splenectomy.

Types of Spleen Removal Surgeries
A splenectomy may be performed as a traditional open surgery or as a laparoscopic, or minimally invasive, procedure. You will be under sedation for either procedure.

Open Splenectomy
Traditional open surgery involves making a cut down the center of your abdomen. The surgeon then moves aside other tissues to remove your spleen. The incision is then closed with stitches. Open surgery is preferred if you have scar tissue from other surgeries or if your spleen has ruptured.

Laparoscopic Splenectomy
This type of surgery is minimally invasive and has a quicker and less painful recovery time than open surgery. In a laparoscopic splenectomy, your surgeon makes just a few small cuts in your abdomen. Then, they use a small camera to project a video of your spleen onto a monitor. Your surgeon can then remove your spleen with small tools. They’ll then stitch up the small incisions. Your surgeon may decide an open surgery is necessary after viewing your spleen on the camera.