ABSTRACT
CO2 Splenoportography (SPG) was performed in eight patients (five pediatric, three
adult) via percutaneous trans-splenic placement of a 25-gauge needle. Five to thirty cc
of CO2 were injected using the plastic bag delivery system, which filled the majority of
the portal system in all patients with no evidence of bleeding complications. All studies
were performed due to equivocal findings with noninvasive imaging. SPG answered the
necessary questions for surgical planning. We feel that the study is most important in
small infants, who have a higher risk of femoral artery access complications, and
patients with hepatofugal flow, where indirect portography may give a false-positive
diagnosis of portal vein occlusion.
